Tetzlaff J E, Dilger J A, Wu C, Smith M P, Bell G
Department of Anesthesiology, Cleveland Clinic Foundation, Ohio 44195, USA.
Reg Anesth Pain Med. 1998 Nov-Dec;23(6):560-3. doi: 10.1016/s1098-7339(98)90081-5.
Paresthesia occasionally occurs during dural puncture or injection of local anesthetic for spinal anesthesia. Although the incidence of neurologic complications after spinal anesthesia is extremely low, the significance of paresthesia is unknown. The influence of known lumbar spine pathology on the incidence of paresthesia during spinal anesthesia is studied.
Incidence of paresthesia with dural puncture (PP) or injection (PI) was studied in two groups of patients. Group 1 included patients for elective total joint replacement without known spine pathology or complaints. Group 2 included patients for elective lumbar spine surgery who received spinal anesthesia.
Significantly more PP (20% vs 9%) and PI (16% vs 6%) occurred in the spine surgery group. There were no neurologic sequelae of spinal anesthesia.
This information suggests that the incidence of paresthesia during the conduct of spinal anesthesia is higher in patients with lumbar spine pathology. Although there were no neurologic complications, the sample size is too small to exclude an increase in the neurologic risk of spinal anesthesia in patients with known intraspinal pathology.
在硬膜穿刺或注射局部麻醉药进行脊髓麻醉时偶尔会发生感觉异常。尽管脊髓麻醉后神经并发症的发生率极低，但感觉异常的意义尚不清楚。本研究探讨已知腰椎病变对脊髓麻醉期间感觉异常发生率的影响。
在两组患者中研究硬膜穿刺（PP）或注射（PI）时感觉异常的发生率。第1组包括无已知脊柱病变或主诉的择期全关节置换患者。第2组包括接受脊髓麻醉的择期腰椎手术患者。
脊柱手术组的PP（20%对9%）和PI（16%对6%）发生率明显更高。脊髓麻醉无神经后遗症。
该信息表明腰椎病变患者在脊髓麻醉过程中感觉异常的发生率更高。尽管没有神经并发症，但样本量太小，无法排除已知脊髓内病变患者脊髓麻醉神经风险增加的可能性。
