González-Carrasco F J, Aguilar J L, Llubiá C, Nogués S, Vidal-López F
Department of Anesthesiology, Hospital Universitario de Badalona, Germans Trias i Pujol, Barcelona, Spain.
Reg Anesth. 1993 May-Jun;18(3):193-5.
BACKGROUND. Pneumocephalus developed in a 45-year-old woman after epidural anesthesia was performed to treat her low back pain. The cause was thought to be the loss of resistance to air technique. The clinical symptoms were immediate headache independent of posture, pallor, bradycardia, and hypotension. These symptoms disappeared during the first 24 hours with no neurologic sequelae. CONCLUSION. This case suggests that using the loss of resistance technique with saline versus air should prevent this complication, especially after unintentional dural puncture or when, in difficult placements, the technique is repeated frequently in the same patient.
背景。一名45岁女性在接受硬膜外麻醉治疗腰痛后发生了气颅。病因被认为是空气阻力消失技术。临床症状为与体位无关的即刻头痛、面色苍白、心动过缓和低血压。这些症状在最初24小时内消失，无神经后遗症。结论。该病例表明，与使用空气相比，使用生理盐水的阻力消失技术应可预防这种并发症，尤其是在意外硬膜穿破后或在困难置管时同一患者频繁重复该技术的情况下。
