Klöss T, van Deyk K, Hempel V
Reg Anaesth. 1984 Jul;7(3):98-100.
A 71 year-old woman was admitted for transurethral resection of bladder carcinoma. The procedure was performed under spinal anaesthesia with mepivacaine 4% hyperbaric. The procedure was carried out without any technical problems. Despite appropriate positioning the patients spinal anaesthesia spread slowly cephalad. 60 minutes after injection of the local anaesthetic aphonia and respiratory insufficiency occurred. The patient was intubated and controlled ventilation was started. 4 hours later the tube could be removed again. 6.5 hours after performing the block no residual block could be detected. The authors discuss the aetiology of this rare complication. It is recommended to keep all patients under continuous anaesthesiologic supervision where the spread of spinal anaesthesia is not definitely declining.
一名71岁女性因膀胱癌行经尿道膀胱肿瘤切除术。手术在4%高压甲哌卡因脊髓麻醉下进行。手术过程未出现任何技术问题。尽管体位合适，但患者的脊髓麻醉仍缓慢向头侧扩散。注射局部麻醉药60分钟后，患者出现失音和呼吸功能不全。对患者进行了气管插管并开始控制通气。4小时后导管再次拔除。实施阻滞6.5小时后未检测到残留阻滞。作者讨论了这种罕见并发症的病因。建议在脊髓麻醉扩散情况未明确减退时，对所有患者进行持续的麻醉学监测。
