一例择期剖宫产患者发生脊髓性肌阵挛的病例。
A case of spinal myoclonus in a patient with elective cesarean section.
作者信息
Shiratori Tohru, Hotta Kunihisa, Satoh Masaaki, Kondo Naoko, Ikeda Junji, Sasao Shinji
机构信息
Department of Anesthesiology, Ina Central Hospital, 1313-1 Koshiroukubo, Ina, Nagano, 396-8555, Japan.
Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
出版信息
JA Clin Rep. 2018 Jun 18;4(1):47. doi: 10.1186/s40981-018-0182-1.
BACKGROUND
Transient myoclonic involuntary movements, typically referred to as spinal myoclonus (SM), rarely develop in the extremities following neuraxial anesthesia (NA). NA indications in patients with history of SM following NA (SM-NA) are unknown.
CASE PRESENTATION
A 33-year-old woman developed SM-NA after elective cesarean section (CS). Approximately 130 min after spinal anesthesia induction, she began exhibiting involuntary movements, which became most severe after approximately 3 h. The involuntary movements gradually decreased without treatments and disappeared after approximately 5 h. The patient underwent CS on three occasions. The first CS (age, 29 years) was under a combination of spinal and epidural anesthesia. The third CS (age, 35 years) was completed using only spinal anesthesia. There were no neurological events during the postoperative courses for the first and third CS.
CONCLUSIONS
SM-NA can unexpectedly occur, and history of SM-NA may not be contraindicative for repeated NA.
背景
短暂性肌阵挛性不自主运动，通常称为脊髓性肌阵挛（SM），在神经轴索麻醉（NA）后很少在四肢出现。既往有NA后SM病史（SM-NA）患者的NA适应证尚不清楚。
病例介绍
一名33岁女性在择期剖宫产（CS）后发生SM-NA。脊髓麻醉诱导后约130分钟，她开始出现不自主运动，约3小时后最为严重。不自主运动未经治疗逐渐减轻，约5小时后消失。该患者接受了3次CS。第一次CS（29岁）采用脊髓和硬膜外联合麻醉。第三次CS（35岁）仅采用脊髓麻醉完成。第一次和第三次CS术后过程中均未发生神经事件。
结论
SM-NA可能意外发生，既往有SM-NA病史可能并非重复NA的禁忌证。
Zotero 插件