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在感染情况下重复进行外科治疗时的硬膜外麻醉。

Extradural anaesthesia for repeated surgical treatment in the presence of infection.

作者信息

Jakobsen K B, Christensen M K, Carlsson P S

机构信息

Department of Anaesthesia, Aarhus University Hospital, Denmark.

出版信息

Br J Anaesth. 1995 Nov;75(5):536-40. doi: 10.1093/bja/75.5.536.

Abstract

The use of extradural catheters in patients with systemic or localized infection is controversial. The catheter may act as a focus for secondary infection resulting in an extradural abscess. in this study we have examined the use of extradural catheters for anaesthesia over the past 7 yr in patients with localized infections. The records of 69 patients were reviewed and patients interviewed (letter/phone). These patients had a total of 120 extradural catheters placed and received, on average, four anaesthetics, with the extradural catheter remaining in place for a mean of 9 days. On 12 occasions (eight patients) the catheter was removed because of signs or symptoms of local infection. Specific antibiotic therapy was not initiated, but ongoing therapy was continued. A single case of spondylitis was the only serious complication found but was not related to the extradural technique. We conclude that extradural anaesthesia for patients who require repeated surgical treatments for abscesses or infected wound is a relatively safe procedure.

摘要

在患有全身性或局部感染的患者中使用硬膜外导管存在争议。导管可能成为继发感染的病灶,导致硬膜外脓肿。在本研究中,我们调查了过去7年中硬膜外导管在局部感染患者麻醉中的使用情况。回顾了69例患者的记录并对患者进行了访谈(信件/电话)。这些患者共置入了120根硬膜外导管,平均接受了4次麻醉,硬膜外导管平均留置9天。有12次(8例患者)因局部感染的体征或症状而拔除导管。未开始使用特定的抗生素治疗,但继续进行正在进行的治疗。仅发现1例脊柱炎为严重并发症,但与硬膜外技术无关。我们得出结论,对于因脓肿或感染伤口需要反复手术治疗的患者,硬膜外麻醉是一种相对安全的操作。

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