Schwartzmann A, Rodríguez A, Castromán P
Departamento y Cátedra de Anestesiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Departamento y Cátedra de Anestesiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Rev Esp Anestesiol Reanim (Engl Ed). 2021 Dec;68(10):602-606. doi: 10.1016/j.redare.2020.10.010. Epub 2021 Nov 25.
An infusion of 100 cc of 0,2% potassium chloride was accidental performed through a thoracic epidural catheter, inserted to perioperative analgesia, to a 66 years old man who was scheduled for right hemicolectomy, 48 h after surgery. Paresis of upper limbs, flaccid paralysis of lower limbs and a sensitive level at T8 was observed. An epidural lavage with an initial dose of 20 cc of saline was slowly injected, followed for a saline infusion of 20 cc per hour. Neurologic signs were totally reverted some hours later and 24 h after the incident the physical exam was normal. We reviewed the clinical presentation of the complication and its mechanisms, the more frequent clinical evolution, as well as treatment measures and strategies to prevent the incident.
一名66岁计划行右半结肠切除术的男性患者,术后48小时,通过用于围手术期镇痛的胸段硬膜外导管意外输注了100毫升0.2%的氯化钾。观察到上肢轻瘫、下肢弛缓性麻痹以及T8感觉平面。缓慢注入初始剂量为20毫升生理盐水的硬膜外灌洗,随后每小时输注20毫升生理盐水。数小时后神经体征完全恢复,事件发生24小时后体格检查正常。我们回顾了该并发症的临床表现及其机制、最常见的临床演变情况,以及预防该事件的治疗措施和策略。