Rockemann M G, Seeling W
Universitätsklinik für Anaesthesiologie, Klinikum der Universität Ulm, Donau.
Reg Anaesth. 1990 Mar;13(2):36-8.
Two cases of secondary subarachnoidal dislocation of lumbar epidural catheters are reported. The first catheter was placed, tested, and injected with 20 ml local anesthetic in order to achieve intraoperative anesthesia up to the T4 level. On the 2nd postoperative day the test dose produced paralysis of the lower extremities; liquor now could be aspirated. The second catheter had been introduced into the epidural space immediately after injection of 15 ml local anesthetic through the needle. Use of this catheter for postoperative analgesia led to total spinal anesthesia in spite of negative aspiration and test dose prior to injection of 7 ml local anesthetic. Implications of these two cases concerning placement procedures and monitoring during reuse of catheters placed some time before are discussed.
本文报告了两例腰椎硬膜外导管继发性蛛网膜下腔移位的病例。第一根导管放置、测试后,注入20毫升局部麻醉剂,以实现高达T4水平的术中麻醉。术后第2天,试验剂量导致下肢麻痹;此时可抽出脑脊液。第二根导管在通过针头注入15毫升局部麻醉剂后立即置入硬膜外腔。尽管在注入7毫升局部麻醉剂之前进行了负压抽吸和试验剂量测试,但使用该导管进行术后镇痛仍导致了全脊髓麻醉。讨论了这两例病例对先前放置一段时间的导管再次使用时的放置程序和监测的影响。