Tassone Rosalie F, Seefelder Christian, Sethna Navil F
Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
Case Rep Anesthesiol. 2012;2012:732584. doi: 10.1155/2012/732584. Epub 2012 Jan 30.
Objective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated complete unilateral extensive epidural sensory and motor blockade with Horner's syndrome after thoracic epidural catheter placement. This unusual presentation of complete hemibody neural blockade has not been reported in the pediatric population. Maneuvers to improve contralateral uniform neural blockade were unsuccessful. An epidurogram was performed to ascertain the correct location of the catheter within the epidural space and presence of sagittal compartmentalization. Conclusion. This case report highlights a less frequently reported reason for unilateral sensory and motor blockade with epidural anesthesia in children. The presence of a midline epidural septum should be considered in the differential diagnosis of unilateral epidural blockade.
目的。硬膜外麻醉已知会发生单侧感觉和运动阻滞，但在儿童中很少有报道。鉴别诊断应包括是否存在中线硬膜外隔。病例报告。我们描述了一例16岁青少年的病例，该患者在胸段硬膜外导管置入后出现反复的完全性单侧广泛硬膜外感觉和运动阻滞并伴有霍纳综合征。这种完全性半身神经阻滞的不寻常表现尚未在儿科人群中报道。改善对侧均匀神经阻滞的操作未成功。进行了硬膜外造影以确定导管在硬膜外间隙内的正确位置以及矢状分隔的存在情况。结论。本病例报告强调了儿童硬膜外麻醉单侧感觉和运动阻滞较少报道的一个原因。在单侧硬膜外阻滞的鉴别诊断中应考虑中线硬膜外隔的存在。
