Bartos Adrian, Breazu Caius-Mihai, Bartos Dana, Mitre Calin Iosif
Department of Surgery, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj-Napoca, Romania.
Department of Anesthesiology and Intensive Care Medicine, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj-Napoca, Romania.
Turk J Anaesthesiol Reanim. 2020 Feb;48(1):71-74. doi: 10.5152/TJAR.2019.15564. Epub 2019 Nov 18.
We report a case of spinal cord injury following an attempted epidural in a conscious woman for pain management in acute pancreatitis. The epidural needle was inserted at the T11-T12 interspace. On the second attempt, dural puncture occurred. The patient did not complain of pain or discomfort during the procedure. Thirty-two hours after the attempted epidural, the patient was found to have motor deficit on her right lower limb. Magnetic resonance imaging showed a spinal haematoma with direct spinal cord injury. Post-laminectomy neurological recovery was slow but progressive. The possible causes for spinal cord injury and spinal haematoma without pain or paraesthesia during the procedure are discussed.
我们报告了一例在一名清醒女性身上进行硬膜外穿刺以治疗急性胰腺炎疼痛时发生脊髓损伤的病例。硬膜外针在胸11-胸12间隙插入。第二次穿刺时发生了硬膜穿刺。术中患者未诉疼痛或不适。硬膜外穿刺尝试32小时后，发现患者右下肢出现运动功能障碍。磁共振成像显示脊髓血肿伴直接脊髓损伤。椎板切除术后神经功能恢复缓慢但呈进行性。文中讨论了术中脊髓损伤和脊髓血肿但无疼痛或感觉异常的可能原因。
