剖腹产脊髓麻醉后颅内硬膜外血肿:病例报告。

Pub Date : 2024-10-07 DOI:10.1186/s40981-024-00744-x
Hiroshi Nagasaka, Yuta Horikoshi, Tina Nakamura, Hiroshi Hoshijima, Noritaka Imamachi, Katsushi Doi, Tsutomu Mieda
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引用次数: 0

摘要

背景:虽然硬膜下血肿是脊髓麻醉后的罕见并发症,但目前还没有脊髓麻醉下剖宫产术后出现颅内硬膜外血肿的报道:一名 32 岁的无阴道产妇在双胞胎妊娠第 35 周时因第一次宫缩而接受了紧急剖宫产手术。她术前没有任何并发症,脊髓麻醉也很顺利,从 L3/4 椎间隙使用 0.5% 布比卡因 12 毫克和芬太尼 15 微克。脊髓麻醉后 15 分钟,她主诉头痛和恶心,显示术后出现意识障碍。剖宫产术后 2 小时,计算机断层扫描显示她有颅内硬膜外血肿。1 小时后,她接受了开颅减压手术:本病例强调了低风险产科病人可能出现的颅内硬膜外血肿。
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Intracranial epidural hematoma after spinal anesthesia for cesarean section: a case report.

Background: Although subdural hematoma is a rare complication after spinal anesthesia, there have been no reports of an intracranial epidural hematoma after cesarean section with spinal anesthesia.

Case presentation: A 32-year-old nulliparous woman at the 35th week of a twin pregnancy underwent an emergency cesarean section due to her first contraction. She had no preoperative complications and the spinal anesthesia was uneventful, with 0.5% bupivacaine 12 mg and fentanyl 15 µg from the L3/4 intervertebral space. She complained of headache and nausea 15 min after spinal anesthesia, demonstrating a consciousness disturbance after surgery. Computed tomography 2 h after the cesarean section revealed an intracranial epidural hematoma. She underwent decompressive craniotomy 1 h later.

Conclusion: This case highlights the possible development of an intracranial epidural hematoma in low-risk obstetric patients.

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