Mocan M, Gamulin Z, Klopfenstein C E, Forster A
Département d'Anesthésiologie, Hôpital Cantonal Universitaire, Genève, Suisse.
Can J Anaesth. 1989 Nov;36(6):708-12. doi: 10.1007/BF03005427.
Two cases of subdural catheter placement following continuous spinal and continuous epidural anaesthesia are presented. In the first, despite an easy reflux of clear cerebrospinal fluid through the catheter, the injection of 4 ml bupivacaine 0.5 per cent with epinephrine 1:200,000 followed by 3 ml tetracaine 0.5 per cent showed a failure of spinal anesthesia. In the second, the administration through the catheter of 20 ml lidocaine 2.0 per cent CO2 plus epinephrine 1:200,000 and of ten ml bupivacaine 0.5 per cent lead to an insufficient, patchy and asymmetrical analgesia. The clinical signs observed in these two cases are compared with previous publications. The importance of an x-ray contrast study to confirm the diagnosis of subdural catheter insertion is stressed.
本文介绍了两例在连续脊麻和连续硬膜外麻醉后放置硬膜下导管的病例。第一例中，尽管脑脊液通过导管顺利回流，但注射4毫升0.5%布比卡因加1:200,000肾上腺素，随后注射3毫升0.5%丁卡因，脊麻仍失败。第二例中，通过导管注射20毫升2.0%利多卡因加二氧化碳加1:200,000肾上腺素以及10毫升0.5%布比卡因，导致镇痛不足、呈斑片状且不对称。将这两例中观察到的临床体征与先前的文献进行了比较。强调了通过X线造影研究来确诊硬膜下导管置入的重要性。
