Hilbert T, Boehm O, Pflugmacher R, Wirtz D C, Baumgarten G, Knuefermann P
Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland,
Anaesthesist. 2014 Jan;63(1):41-6. doi: 10.1007/s00101-013-2279-2. Epub 2014 Jan 10.
Surgical treatment of the lumbar spine is a standard procedure in orthopedic and neurosurgery. After endoscopic discectomy an otherwise healthy patient developed massive dyspnea in combination with severe abdominal pain. Sonography revealed a large volume of free fluid in the abdominal cavity which proved to be surgical irrigation solution after computed tomography (CT) guided puncture. After insertion of a drainage channel fluid could be removed and the patient was transferred to a peripheral ward after a 24 h monitoring period. This review reports on the complications and anesthetic characteristics of percutaneous spinal interventions and presents differential diagnoses of postoperative dyspnea.
腰椎手术是骨科和神经外科的标准手术。一名原本健康的患者在接受内镜下椎间盘切除术后出现了严重的呼吸困难并伴有剧烈腹痛。超声检查显示腹腔内有大量游离液体,经计算机断层扫描(CT)引导穿刺后证实为手术冲洗液。插入引流管后液体得以排出,患者在经过24小时监测期后被转至普通病房。本综述报告了经皮脊柱介入手术的并发症和麻醉特点,并提出了术后呼吸困难的鉴别诊断。