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