Shimauchi Tsukasa, Yoshino Jun, Fujimura Naoyuki
Department of Anesthesiology, St. Mary's Hospital, Kurume, Fukuoka, Japan.
Quebec Lung and Heart Institute, Laval University, 2725 Chemin Ste-Foy, Quebec, QC, G1V 4G5, Canada.
JA Clin Rep. 2021 Sep 28;7(1):72. doi: 10.1186/s40981-021-00476-2.
Neurotoxicity caused by a local anesthetic after regional anesthesia is a rare but serious problem for anesthesiologists. It is difficult to diagnose neurotoxicity from anesthetics because of the large number of possible diagnoses. In this case report, careful monitoring by neurological examinations helped to diagnose local neurotoxicity caused after epidural anesthesia.
A 41-year-old pregnant woman who underwent emergency cesarean delivery under combined spinal-epidural anesthesia suffered left leg paralysis after surgery. Multiple neurological examinations (e.g., electromyography, nerve conduction study) revealed that the paralysis was induced by the neurotoxicity of ropivacaine. The neurological examinations were also useful to monitor the recovery process.
This is the first clinical case report that describes the diagnosis of and recovery from local anesthesia-induced neurotoxicity monitored by electromyography and nerve conduction study. Neurological disorders caused by regional anesthetics should be carefully examined and diagnosed using these neurological examinations.
区域麻醉后局部麻醉药引起的神经毒性对麻醉医生来说是一个罕见但严重的问题。由于可能的诊断众多，很难从麻醉药中诊断出神经毒性。在本病例报告中，通过神经学检查进行仔细监测有助于诊断硬膜外麻醉后引起的局部神经毒性。
一名41岁的孕妇在腰麻-硬膜外联合麻醉下接受了急诊剖宫产手术，术后出现左腿麻痹。多项神经学检查（如肌电图、神经传导研究）显示，麻痹是由罗哌卡因的神经毒性引起的。神经学检查对于监测恢复过程也很有用。
这是第一份临床病例报告，描述了通过肌电图和神经传导研究监测局部麻醉引起的神经毒性的诊断和恢复情况。应由这些神经学检查仔细检查和诊断由区域麻醉药引起的神经障碍。
