Rostami Daryoush, Pormasoumi Hosien, Jamebozorgi Khosro, Sadegi Kambiz
School of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol.
Faculty of Medicine, Zabol University of Medical Sciences, Zabol.
Eur J Transl Myol. 2022 Dec 1;33(1):10778. doi: 10.4081/ejtm.2022.10778.
The aim of this study was to assess the epidural and subdural hematoma following spinal anesthesia in infants' rat model. We investigated during 10, 15, and 20 days' rats in group 1: intrathecal injection of bupivacaine 3.75 mg/kg (n = 7); group 2: received 37.5 μl midazolam 0.1% intrathecal with 37.5μl fentanyl 0.005% (no=7); injected into group 3 methylene blue 1 mg/ml (No. 7). Rats were exposed to spinal anesthesia in infancy and rotarod in motor function in adulthood. Histological evaluation and tissue extraction were also performed after the treatment and magnetic resonance imaging (MRI) of the head. MRI of the head of all rat pups that showed similar symptoms were performed. 4 rat pups showed the symptoms of hematoma Group1: small acute subdural hematoma at the left posterior temporal-parietal junction (PTPJ) and group 2 (one: right temporal epidural hematoma, two: Small acute subdural hematoma in the right temporomandibular area, and three: frontal-temporal-parietal-occipital hematoma). the rat pup that had epidural hematoma died 6 hours later. Finally, in the first group, one rat and the second group three rats showed hematoma symptoms. For these three rats, a histopathologic study was performed and indicate the presence of small acute subdural hematoma at the left posterior temporal-parietal junction, right temporal epidural hematoma, and frontal-temporal-parietal-occipital hematoma. In summary, because subdural or epidural hematoma of the skull can have serious consequences, differential diagnosis is very important for pain after spinal anesthesia.
本研究的目的是评估幼鼠模型中脊髓麻醉后的硬膜外和硬膜下血肿。我们在第1组的10日龄、15日龄和20日龄大鼠中进行了研究：鞘内注射布比卡因3.75 mg/kg（n = 7）；第2组：鞘内注射37.5 μl 0.1%咪达唑仑和37.5 μl 0.005%芬太尼（n = 7）；第3组注射1 mg/ml亚甲蓝（n = 7）。大鼠在幼年时接受脊髓麻醉，并在成年后进行转棒试验以评估运动功能。治疗后还进行了组织学评估、组织提取以及头部的磁共振成像（MRI）。对所有表现出相似症状的幼鼠进行了头部MRI检查。4只幼鼠出现血肿症状：第1组：左侧后颞顶交界处（PTPJ）有小的急性硬膜下血肿；第2组（1只：右侧颞部硬膜外血肿，2只：右侧颞下颌区域小的急性硬膜下血肿，3只：额颞顶枕部血肿）。出现硬膜外血肿的幼鼠在6小时后死亡。最后，第1组有1只大鼠、第2组有3只大鼠出现血肿症状。对这3只大鼠进行了组织病理学研究，结果显示左侧后颞顶交界处有小的急性硬膜下血肿、右侧颞部硬膜外血肿以及额颞顶枕部血肿。总之，由于颅骨硬膜下或硬膜外血肿可能会产生严重后果，因此脊髓麻醉后疼痛的鉴别诊断非常重要。
