与产科镇痛有关的硬膜外广泛性肺出血

M.J. Garcia-Cebrián , I.M. Fontan-Atalaya , J. Garcia-Perez , B. Fernandez-Torres
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引用次数: 0

摘要

先天性硬膜外积气是一种罕见的临床现象,但麻醉医师在使用空气技术鉴定硬膜外腔时应注意这种可能性。尽管在大多数已发表的病例中,硬膜外积气是无症状的,但也有相关神经系统后果的描述,如脑膜刺激、根性疼痛、单侧下肢无力、马尾综合征、截瘫和四肢瘫痪。我们描述了一名产钳助产后会阴部疼痛剧烈且不典型的患者发生的与产科镇痛有关的广泛硬膜外积气(T9-S1)。我们的目的是综合整理现有的科学证据,分析预防措施,总结症状性疾病最合适的诊断、随访和治疗技术,其中包括高浓度吸氧、高压氧疗法、经皮或手术减压。
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Extensive extradural pneumorrhachis related to obstetric analgesia

Iatrogenic extradural pneumorrhachis is a rare clinical entity, but anesthesiologists should be aware of this possibility when using the air technique for the identification of epidural space. Although in most published cases extradural pneumorrhachis is asymptomatic, relevant neurological consequences have been described, such as meningeal irritation, radicular pain, unilateral lower extremity weakness, cauda equina syndrome, paraplegia, and tetraplegia.We describe a very extensive extradural pneumorrachis (T9-S1), related to obstetric analgesia, in a patient with severe and atypical perineal pain after forceps-assisted delivery. Our aim is to synthesize and organize the available scientific evidence, analyzing preventive measures and summarizing the most appropriate diagnostic, follow-up and therapeutic techniques for symptomatic conditions, among which high concentrations of inspired oxygen, hyperbaric oxygen therapy and percutaneous or surgical decompression have been described.

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