Epidural Anesthesia for Caesarean Section and Occurrence of Horner’s Syndrome

S. Spasovski, A. Sivevski, D. Karadjova, I. Samardžiski
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Abstract

Abstract Recently, specifically in the last decade, at the University Clinic of Gynecology and Obstetrics, the number of patients treated with epidural analgesia for painless childbirth, which in some percentage ends in Caesarian section (35%), has increased. The increased use of the epidural anesthesia and analgesia is due to the fact that it is one of the most popular ways of childbirth today. This situation is a result of the benefits that epidural anesthesia has for the patient, which consist of allowing the pregnant woman to be conscious during childbirth and to feel and see her child coming into the world, accompanied with smaller intensity of intraoperative and postoperative pain. However, the results or the effects in practice have shown that in certain insignificant percentage patients can have negative consequences from the received analgesia (anesthesia) such as: headache, cases of durra puncture, epidural abscess or hematoma, neurological outbursts etc. But, the subject of this analysis or the aim of this study is the appearance of Horner’s syndrome, as one of the negative effects of the epidural anesthesia, which even though rarely (only in 1% of the cases) can appear as a result of the epidural anesthesia. In the case study using the historic, comparative and empirical method we will try through a specific case to determine the causes for the occurrence of the Horner’s syndrome, how it should be treated and what are the consequences for the patient.
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剖宫产硬膜外麻醉与Horner综合征的发生
摘要最近,特别是在过去的十年里,在大学妇产科诊所,接受硬膜外镇痛无痛分娩治疗的患者数量有所增加,在一定程度上,剖腹产(35%)结束了硬膜外镇痛。硬膜外麻醉和镇痛的使用增加是因为它是当今最流行的分娩方式之一。这种情况是硬膜外麻醉对患者有益的结果,硬膜外麻醉可以让孕妇在分娩时保持清醒,感受和看到她的孩子来到这个世界,同时减轻术中和术后的疼痛。然而,实践中的结果或效果表明,在某些不显著的百分比中,患者可能会因接受镇痛(麻醉)而产生负面后果,如:头痛、硬膜外穿刺、硬膜外脓肿或血肿、神经系统爆发等。但是,本分析的主题或本研究的目的是霍纳综合征的出现,作为硬膜外麻醉的负面影响之一,尽管硬膜外麻醉很少(只有1%的病例)会出现这种情况。在使用历史、比较和经验方法的案例研究中,我们将尝试通过一个特定的案例来确定霍纳综合征发生的原因、应该如何治疗以及对患者的后果。
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