脊髓性罗哌卡因在产科患者中的暂时性神经并发症。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Agri-The Journal of the Turkish Society of Algology Pub Date : 2022-01-01 DOI:10.14744/agri.2019.25986
Nurten Kayacan, Bilge Karslı
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引用次数: 1

摘要

我们的目的是了解脊髓麻醉后短暂的神经系统症状,并回顾产后区域麻醉的神经功能缺损。一名健康的25岁初产妇接受了选择性剖宫产手术。术中未见低血压、心动过缓。产后第25天,患者出现下肢麻木无力。在神经学评估中,两侧腓肠肌和股四头肌的肌力分别为2/5(+)和3/5(+)。双侧足背屈和足底屈的肌力为2/5(+)。患者不能用脚尖行走,也不能用脚跟行走,下肢有假感。双侧髌骨和跟腱反射均为阴性。腰骶部磁共振成像未见病理改变。肌电图显示混合型多发性神经病。第2月末症状部分缓解,第3月末症状完全消退。为了预防不可逆的产后永久性神经功能缺损,诊断应使用详细的神经系统检查以及MRI或计算机断层扫描。
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Temporary neurologic complication of spinal ropivacaine in an obstetric patient.

We aimed to inform transient neurological symptoms after spinal anesthesia and to review postpartum neurological deficits of regional anesthesia. A previously healthy 25-year-old primigravid woman underwent an elective cesarean section. Hypotension and bradycardia were not observed during the operation. On the 25th day postpartum, the patient suffered from numbness and weakness at the lower extremity. On neurological assessment, the muscle strengths in the gastrocnemius and quadriceps bilaterally were 2/5 (+) and 3/5 (+), respectively. The muscle strength at foot dorsiflexion and plantar flexion were 2/5 (+) bilaterally. The patient was unable to walk on toes and walked on heels, and the lower extremities were hypoesthetic. The patellar and the Achilles tendon reflexes were bilaterally negative. No pathological findings could be detected on lumbosacral magnetic resonance imaging (MRI). Electromyography revealed a mixed type of polyneuropathy. The symptoms relieved partially at the end of the 2nd month and regressed completely at the end of the 3rd month. To prevention of irreversible postpartum permanent neurologic deficits, the diagnosis should be made using a detailed neurologic examination along with MRI or computed tomography.

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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
22
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