Rosenberg S K, Stacey B R
Department of Anesthesiology, Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Reg Anesth. 1996 Sep-Oct;21(5):486-9.
A 58-year-old man developed progressive neurologic symptoms following a surgical procedure and postoperative epidural analgesia.
Neurologic evaluation, magnetic resonance imaging, computed tomography, and electromyography indicated the presence of both arachnoiditis and Guillain-Barré syndrome. The patient was treated with plasmapheresis and methylprednisone.
The patient began to show clinical and electromyographic recovery but was lost to follow-up after his transfer to a rehabilitation facility.
Anesthesiologists should be aware of the possible postoperative occurrence of rare neurologic disorders, both in patients who have received epidural analgesia and in those who have not, but they should not be deterred from using epidural analgesia by this isolated case.
一名58岁男性在接受外科手术及术后硬膜外镇痛后出现进行性神经症状。
神经学评估、磁共振成像、计算机断层扫描及肌电图检查表明存在蛛网膜炎和吉兰 - 巴雷综合征。患者接受了血浆置换和甲基强的松龙治疗。
患者开始出现临床及肌电图恢复,但转至康复机构后失访。
麻醉医生应意识到,无论患者是否接受硬膜外镇痛,术后都可能发生罕见的神经疾病,但不应因这一孤立病例而不敢使用硬膜外镇痛。