German Regional Anaesthesia Network, Department of Anaesthesiology, Intensive Care and Pain Medicine, Saarland University Hospital, Homburg, Germany.
Eur J Anaesthesiol. 2012 Apr;29(4):170-6. doi: 10.1097/EJA.0b013e3283504fec.
The incidence of epidural haematoma after epidural anaesthesia is uncertain.
To quantify epidural haematoma after epidural anaesthesia in 2008 and 2009 in a network for safety in regional anaesthesia in Germany.
Analysis of data systematically documented within the German network for safety in regional anaesthesia.
A regional anaesthesia register for clinics recording their clinical practice was set up according to a consented protocol. After checking the registry for the presence of epidural haematoma, all participating centres were asked for the number of epidural haematoma and the number of neuraxial procedures performed during the 2 years. Patient-specific information regarding procedures and outcome were requested.
The incidence of epidural haematoma in the network with comorbidities, coagulation status and time from first symptoms, also the performance of MRI and laminectomy.
During a period of 2 years, 33,142 non-obstetric epidural blocks were performed. Five thoracic epidural and one cranial haematoma occurred.
The incidence of spinal haematoma was 1: 6 628 in this general surgical population. When local anaesthetics are continuously applied, progressive motor block should increase the level of suspicion. When accompanied by pain or paraesthesia, progression to diagnosis by MRI is mandatory.
硬膜外麻醉后硬膜外血肿的发生率尚不确定。
在德国区域麻醉安全网络中量化 2008 年和 2009 年硬膜外麻醉后硬膜外血肿的发生率。
对德国区域麻醉安全网络中系统记录的数据进行分析。
根据同意的方案，为记录其临床实践的诊所设立了一个区域麻醉登记处。在检查登记处是否存在硬膜外血肿后，向所有参与中心询问这两年期间硬膜外血肿和脊柱内操作的数量。还要求提供有关程序和结果的患者具体信息。
合并症、凝血状态和首发症状后时间等因素下网络中硬膜外血肿的发生率，以及 MRI 和椎板切除术的实施情况。
在 2 年期间，共进行了 33142 例非产科硬膜外阻滞。发生了 5 例胸椎硬膜外血肿和 1 例颅血肿。
在一般外科人群中，脊柱血肿的发生率为 1:6628。当局部麻醉剂持续应用时，进行性运动阻滞应增加怀疑程度。当伴有疼痛或感觉异常时，必须通过 MRI 进行诊断。
