Smith Kathleen A, Ray Adrienne P
Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA.
J Anaesthesiol Clin Pharmacol. 2011 Jul;27(3):377-9. doi: 10.4103/0970-9185.83686.
A patient with Klippel-Feil syndrome, morbid obesity, and scoliosis required cesarean delivery. Her previous cesarean deliveries were performed under general anesthesia. She desired a regional technique. Following aspiration prophylaxis and placement of standard monitors, ultrasound was used to identify midline and L(2-3) interspace. Unintentional dural puncture occurred at 10 cm, with an inability to advance the catheter. On second attempt, an epidural catheter was placed easily. After negative test dose, 18 ml of 2% lidocaine with epinephrine was administered to the patient. A T4 level was achieved. The patient tolerated surgery well. Complete block resolution occurred at 4 hours with no neurologic sequelae.
一名患有克利珀尔-费尔综合征、病态肥胖和脊柱侧凸的患者需要剖宫产。她之前的剖宫产是在全身麻醉下进行的。她希望采用区域阻滞技术。在进行预防误吸措施并放置标准监测设备后，使用超声确定中线和腰2-3间隙。在进针10厘米时意外发生硬膜穿破，导管无法推进。第二次尝试时，硬膜外导管轻松置入。试验剂量无异常反应后，给患者注射了18毫升含肾上腺素的2%利多卡因。达到了T4节段的阻滞平面。患者手术耐受良好。4小时后阻滞完全消退，无神经后遗症。
