硬膜外分娩镇痛后产后腹侧硬膜外血肿

Puerperal ventral epidural hematoma after epidural labor analgesia.

作者信息

Gruzman I, Shelef I, Weintraub A Y, Zlotnik A, Erez O

机构信息

Division of Anesthesiology and Intensive Care, Soroka University Medical Center, School of Medicine, Faculty Of Health Sciences, Ben Gurion University of the Negeve, Beer Sheva, Israel.

Department of Radiology, Soroka University Medical Center, School of Medicine, Faculty Of Health Sciences, Ben Gurion University of the Negeve, Beer Sheva, Israel.

出版信息

Int J Obstet Anesth. 2017 May;31:100-104. doi: 10.1016/j.ijoa.2017.03.011. Epub 2017 Mar 31.

DOI:10.1016/j.ijoa.2017.03.011

PMID:28499552

Abstract

Serious complications in obstetric anesthesia are a rare occurrence. High neuraxial block, respiratory arrest in labor and delivery, and an unrecognized spinal catheter are among the most frequently reported serious complications. A serious complication occurs in approximately 1:3000 obstetric patients. Neuraxial hematoma after obstetric epidural analgesia or anesthesia is extremely rare. We present a case of a puerperal spinal epidural hematoma following epidural labor analgesia. The patient presented with foot drop, which resolved after conservative treatment. We reviewed the epidemiology, clinical manifestations and treatment options for this rare complication.

摘要

产科麻醉中的严重并发症实属罕见。高位椎管内阻滞、分娩时呼吸骤停以及未被识别的脊髓导管是最常报告的严重并发症。严重并发症大约在每3000例产科患者中出现1例。产科硬膜外镇痛或麻醉后发生的脊髓血肿极为罕见。我们报告一例硬膜外分娩镇痛后发生的产褥期脊髓硬膜外血肿病例。该患者出现足下垂，经保守治疗后症状缓解。我们回顾了这种罕见并发症的流行病学、临床表现及治疗选择。