Goto Hiroto, Matsunaga Matsuko, Higa Kazuo
Department of Anesthesiology, Fukuoka Teishin Hospital, Fukuoka 810-8798.
Masui. 2010 Apr;59(4):498-500.
An epidural catheter was inserted at the T10-11 interspace for the treatment of acute herpetic pain in a 68-year-old woman. Loss of resistance method with saline was used for identifying the epidural space. After negative aspiration test for cerebrospinal fluid and blood, continuous epidural infusion of 0.2% ropivacaine 2 ml x hr(-1) with intermittent injections of 1% mepivacaine 3 ml was performed for 20 days without side effects. However, on the 21st day, Horner's syndrome and weakness of the left arm and leg appeared 10 minutes after injection of 1% mepivacaine 3 ml. The symptoms and signs suggested subdural block. Migration of the epidural catheter into the subdural space may have occurred. Subdural block may occur even if the catheter is initially properly placed in the epidural space.
为一名68岁女性治疗急性疱疹性疼痛时，在T10 - 11椎间隙插入硬膜外导管。采用生理盐水阻力消失法确定硬膜外间隙。在脑脊液和血液抽吸试验为阴性后，持续硬膜外输注0.2%罗哌卡因2 ml·hr⁻¹，并间断注射1%甲哌卡因3 ml，持续20天无副作用。然而，在第21天，注射1%甲哌卡因3 ml后10分钟出现霍纳综合征以及左臂和左腿无力。症状和体征提示硬膜下阻滞。硬膜外导管可能已移入硬膜下间隙。即使导管最初正确置于硬膜外间隙，也可能发生硬膜下阻滞。
