Lee Sang Eun, Choi Rak Min, Kee Rim, Lee Kang Hun, Jeon Sangyoon, Jung Jae-Wook, Kim Woo-Jin, Yoon Jin Sun
Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea.
Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, Korea.
Korean J Anesthesiol. 2015 Apr;68(2):179-83. doi: 10.4097/kjae.2015.68.2.179. Epub 2015 Mar 30.
Spinal cord stimulation (SCS) in trials involving external stimulation are easily conducted under local anesthesia. However, implantation of a permanent SCS system is painful, and can be intolerable in some patients. Epidural anesthesia can be used to perform the SCS implantation without discomfort if the patient can localize the area of paresthesia. However, little is known about epidural anesthesia for SCS. This paper reports 23 cases of permanent SCS with a cylindrical type lead implanted under the epidural anesthesia. Epidural anesthesia was sufficient in 22 patients without discomfort and significant complications. The remaining patient experienced incomplete epidural anesthesia and required additional analgesics to blunt the pain. All the leads were placed consistent with the patient's report of paresthesia area under epidural anesthesia. Thus, epidural anesthesia is an effective and safe method for the optimal placement of SCS to minimize the discomfort for patients without impairing patients' response to the intraoperative stimulation test.
在涉及外部刺激的试验中，脊髓刺激（SCS）很容易在局部麻醉下进行。然而，植入永久性SCS系统很痛苦，在一些患者中可能难以忍受。如果患者能够定位感觉异常区域，硬膜外麻醉可用于进行SCS植入且不会带来不适。然而，关于用于SCS的硬膜外麻醉知之甚少。本文报告了23例在硬膜外麻醉下植入圆柱形导联的永久性SCS病例。22例患者硬膜外麻醉效果良好，无不适和严重并发症。其余1例患者硬膜外麻醉不完全，需要额外的镇痛药来减轻疼痛。所有导联的放置均与患者在硬膜外麻醉下感觉异常区域的报告一致。因此，硬膜外麻醉是一种有效且安全的方法，可用于优化SCS的放置，在不影响患者对术中刺激测试反应的情况下，将患者的不适降至最低。
