Ogawa Shunya, Kanda Hirotsugu, Kurosaki Hiromichi, Kawamata Tomoyuki
Department of Anesthesiology, Wakayama Medical University, Kimiidera 811-1, Wakayama, 641-8509, Japan.
JA Clin Rep. 2024 Feb 21;10(1):15. doi: 10.1186/s40981-024-00698-0.
Nerve injury in epidural labor analgesia can occur with various potential causes. We report a rare case of left common peroneal nerve palsy after delivery caused by a prolonged period of sitting cross-legged during epidural labor.
Epidural labor analgesia in a 28-year-old primipara started at 39 weeks of gestation. She sat cross-legged to prompt delivery for approximately 4 h with a break of a few minutes every hour. She had numbness in her left lower limb and difficulty in dorsiflexion of the ankle joint that did not improve until 3 h after delivery. We made a diagnosis of left common peroneal nerve palsy. Most of the symptoms had improved at 2 months postpartum.
Epidural labor analgesia prevented recognition of prolonged peroneal head compression caused by sitting cross-legged. When this position is used to facilitate delivery, it should be released frequently owing to the possibility of a neurologic deficit.
硬膜外分娩镇痛时神经损伤可能由多种潜在原因引起。我们报告一例罕见的硬膜外分娩期间长时间盘腿坐姿导致产后左侧腓总神经麻痹的病例。
一名28岁初产妇在妊娠39周时开始进行硬膜外分娩镇痛。她盘腿而坐以促进分娩约4小时，每小时休息几分钟。她左下肢麻木，踝关节背屈困难，产后3小时仍未改善。我们诊断为左侧腓总神经麻痹。产后2个月时大部分症状已改善。
硬膜外分娩镇痛使因盘腿坐姿导致的腓骨头长期受压未被察觉。当采用此姿势促进分娩时，由于存在神经功能缺损的可能性，应频繁改变姿势。
