成人尾硬膜外浸润时导管意外断裂:不寻常的并发症。

IF 1.3 Q3 ANESTHESIOLOGY Saudi Journal of Anaesthesia Pub Date : 2024-04-01 Epub Date: 2024-03-14 DOI:10.4103/sja.sja_820_23
Paula Gil Esteller, Sara Navarro, Laura Gómez, Maria Martínez, Carles Espinós
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引用次数: 0

摘要

尾硬膜外阻滞是一种简单、安全、并发症发生率低的技术,常用于小儿麻醉和慢性腰骶部疼痛的治疗。然而,它也不免存在一些风险,尽管这些风险并不常见,但也应有所了解。我们描述了一例患有慢性腰骶部根性疼痛的 48 岁女性病例,她接受了硬膜外腔尾部浸润治疗。在拔出导管的过程中,导管意外断裂,碎片滞留在骶骨硬膜外前间隙。我们选择进行预期管理,定期检查并进行放射学腰骶部计算机断层扫描(CT)。由于导管是在无菌条件下置入的,因此没有考虑预防性抗生素治疗。患者在导管破裂后的 6 个月内未出现任何不良反应。据我们所知,目前还没有成人硬膜外导管在尾部水平破裂的报道。因此,对于如何处理这些病例并没有统一的方案,必须根据患者的具体情况进行处理。
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Accidental catheter breakage during caudal epidural infiltration in an adult: An unusual complication.

Caudal epidural block is a simple and safe technique with a low complication rate commonly used for pediatric anesthesia and treatment of chronic lumbosacral pain. However, it is not exempt from some risks that, although infrequent, should be known. We describe the case of a 48-year-old female with chronic lumbosacral radicular pain who underwent caudal epidural infiltration. During the withdrawal of the catheter, accidental breakage and retention of a fragment at the level of the anterior epidural space of the sacrum occurred. We choose to have an expectant management with regular controls and a radiological lumbosacral computed tomography (CT) scan. Since the catheter was placed under sterile conditions, no prophylactic antibiotic treatment was considered. The patient showed no adverse events during the 6 months following catheter rupture. To our knowledge, there are no reports of epidural catheter breakage at the caudal level in adults. This is why there is no standardized protocol on how to proceed in these cases, and the handling of this situation must be individualized.

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来源期刊
CiteScore
1.90
自引率
8.30%
发文量
141
审稿时长
36 weeks
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