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急诊剖腹探查术硬膜外穿刺时意外硬膜穿破后的连续脊髓麻醉。

Continuous Spinal Anesthesia following Inadvertent Dural Puncture during Epidural Placement for an Emergency Laparotomy.

作者信息

Emyedu Andrew, Kyoheirwe Bernadette, Atumanya Patience

机构信息

Department of Anaesthesia and Critical Care, Makerere University, College of Health Sciences, P.O. Box 7062, Kampala, Uganda.

Department of Anaesthesia, Uganda Cancer Institute, P.O. Box 3935, Kampala, Uganda.

出版信息

Case Rep Anesthesiol. 2021 Mar 8;2021:8819864. doi: 10.1155/2021/8819864. eCollection 2021.

Abstract

. Emergency exploratory laparotomy conducted under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. . Continuous spinal anesthesia is one of the least utilized regional anesthesia techniques globally. It could be an alternative anesthesia technique for abdominal and lower limb surgeries following an accidental dural puncture. The aim of this report was to describe a case in which continuous spinal anesthesia was successfully conducted for emergency exploratory laparotomy following an accidental dural puncture during epidural placement. . A 38-year-old male presented to our accident and emergency unit with a one-day history of colicky abdominal pain associated with constipation, abdominal distension, and vomiting. He was diagnosed with intestinal obstruction and underwent an emergency exploratory laparotomy under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. . This case demonstrates that in case of an accidental dural puncture during epidural placement, the catheter can be advanced into the intrathecal space and continuous spinal anesthesia conducted for abdominal surgeries using a standard epidural catheter.

摘要

. 硬膜外穿刺意外穿破硬膜后,使用标准硬膜外套件在连续脊麻下进行急诊剖腹探查术。. 连续脊麻是全球使用最少的区域麻醉技术之一。它可能是硬膜外穿刺意外穿破硬膜后用于腹部和下肢手术的一种替代麻醉技术。本报告的目的是描述一例在硬膜外置管时意外穿破硬膜后成功进行连续脊麻下急诊剖腹探查术的病例。. 一名38岁男性因绞痛性腹痛伴便秘、腹胀和呕吐一天就诊于我院急诊科。他被诊断为肠梗阻,并在硬膜外穿刺意外穿破硬膜后,使用标准硬膜外套件在连续脊麻下接受了急诊剖腹探查术。. 本病例表明,在硬膜外置管时意外穿破硬膜的情况下,可将导管推进至鞘内空间,并使用标准硬膜外导管进行腹部手术的连续脊麻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d054/7960041/d04bf9622737/CRIA2021-8819864.001.jpg

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