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与硬膜外麻醉相关的截瘫

Paraplegia associated with epidural anesthesia.

作者信息

Adriani J, Naragi M

出版信息

South Med J. 1986 Nov;79(11):1350-5. doi: 10.1097/00007611-198611000-00008.

Abstract

Spinal anesthesia has lost its popularity among physicians due to rare occurrences of paraplegia that have precipitated lawsuits, with staggering judgments in favor of claimants. Epidural block has now become a popular alternative because some believe it cannot cause paraplegia; however, paraplegia is as prevalent after induction of epidural anesthesia as after spinal anesthesia. Arachnoiditis has been incriminated as the causative agent when paraplegia has followed spinal anesthesia. Arachnoiditis is also a causative factor when paraplegia follows epidural block. Cord compression and anterior spinal artery syndrome have also been associated with paraplegia after epidural block though they have not been a problem with spinal block.

摘要

由于罕见的截瘫病例引发了诉讼,并对索赔人作出了惊人的判决,脊髓麻醉在医生中已不再受欢迎。硬膜外阻滞现在已成为一种流行的替代方法,因为一些人认为它不会导致截瘫;然而,硬膜外麻醉诱导后截瘫的发生率与脊髓麻醉后一样高。当脊髓麻醉后发生截瘫时,蛛网膜炎被认为是致病因素。当硬膜外阻滞后发生截瘫时,蛛网膜炎也是一个致病因素。硬膜外阻滞后的截瘫也与脊髓压迫和脊髓前动脉综合征有关,尽管它们在脊髓阻滞中不是问题。

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