Regional anesthesia · 1997
Unexplained neurologic deficit after uneventful combined spinal and epidural anesthesia for cesarean delivery.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Paech M J
Аннотация
BACKGROUND AND OBJECTIVES: Neurologic deficits after spinal and epidural anesthesia are uncommon and have a variety of pathophysiologic mechanisms. Local anesthetic neurotoxicity may occur, although subarachnoid bupivacaine has an unblemished clinical record.
METHODS: A healthy parturient underwent uneventful combined spinal and epidural anesthesia for elective cesarean delivery. Intraspinal drugs administered included hyperbaric bupivacaine 0.5% and fentanyl (subarachnoid) and 2% lidocaine with epinepherine 1:200,000 and meperidine (epidural).
RESULTS: On the third postpartum day the patient reported buttock numbness. An area of hypoesthesia in the distribution of the lower sacral nerves was present, without systemic or other neurologic symptoms and signs. The deficit persisted, and imaging of the lower spinal canal revealed no significant abnormality. Full recovery of sensation occurred after 7 months.
CONCLUSION: Drug-induced neurotoxicity is a possible explanation, although the exact etiology is uncertain.
METHODS: A healthy parturient underwent uneventful combined spinal and epidural anesthesia for elective cesarean delivery. Intraspinal drugs administered included hyperbaric bupivacaine 0.5% and fentanyl (subarachnoid) and 2% lidocaine with epinepherine 1:200,000 and meperidine (epidural).
RESULTS: On the third postpartum day the patient reported buttock numbness. An area of hypoesthesia in the distribution of the lower sacral nerves was present, without systemic or other neurologic symptoms and signs. The deficit persisted, and imaging of the lower spinal canal revealed no significant abnormality. Full recovery of sensation occurred after 7 months.
CONCLUSION: Drug-induced neurotoxicity is a possible explanation, although the exact etiology is uncertain.