Gupta Neha, Gupta Veena, Kumar Abhishake, Kumar Gaurav
Department of Anaesthesia, M. L. B. Medical College, Jhansi, Uttar Pradesh, India.
Department of Orthopaedics, Jhansi Orthopaedic Hospital, Jhansi, Uttar Pradesh, India.
Indian J Anaesth. 2014 Mar;58(2):199-201. doi: 10.4103/0019-5049.130829.
Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.
硬脊膜扩张是脊髓麻醉不全或失败的可能原因之一。它与马凡综合征、神经纤维瘤病、成骨不全、椎体骨折、术后粘连、创伤等疾病的关联,常常被忽视作为脊髓麻醉不足的一个原因。硬脊膜扩张时腰椎蛛网膜下腔内脑脊液量大于正常,据推测这会限制鞘内注射局部麻醉药的扩散。在此,我们报告一例硬脊膜扩张患者脊髓麻醉失败但随后硬膜外麻醉成功的病例。