Moreno-Duarte Ingrid, Hall Robert R, Shutran Max S, Radhakrishnan Manga G, Drzymalski Dan M
From the Department of Anesthesiology and Critical Care.
Neurosurgery, Tufts Medical Center, Boston, Massachusetts.
A A Pract. 2019 Jun 15;12(11):436-437. doi: 10.1213/XAA.0000000000000960.
A lumboperitoneal shunt facilitates dynamic flow of cerebrospinal fluid into the peritoneum. Consequently, neuraxial technique placement in the parturient with a lumboperitoneal shunt can result in unexpected levels of blockade. We present the case of a parturient with a lumboperitoneal shunt who experienced symptoms consistent with high blockade after epidural administration of 450 mg chloroprocaine. This report emphasizes potential mechanisms for high neuraxial blockade and strategies to decrease risks in this unique patient population.
腰大池-腹腔分流术有助于脑脊液向腹膜的动态流动。因此,在有腰大池-腹腔分流术的产妇中进行神经轴技术操作可能会导致意外的阻滞平面。我们报告一例有腰大池-腹腔分流术的产妇,在硬膜外给予450mg氯普鲁卡因后出现了与高位阻滞相符的症状。本报告强调了高位神经轴阻滞的潜在机制以及降低这一特殊患者群体风险的策略。