Transient Neurological Symptoms after Epidural Analgesia: A Case Report

硬脊膜外止痛後發生暫時性神經症候群：病例報告

葉宣德(Hsuan-Te Yeh) ； 陳明山(Ming-Shan Chen) ； 姜翰良(Han-Liang Chiang)

《南臺灣醫學雜誌》 12卷1期 (2016/07) Pp. 38-42

https://doi.org/10.6726/MJST.201607_12(1).0005

摘要

暫時性神經症候群併發症首次被描述於1993年，病患接受5%利多卡因做為脊髓麻醉劑並在截石體位下進行手術，術後在臀部、大腿或下肢發生刺痛感卻未伴隨任何相關性神經異常與實驗室數據異常。此症候群發生於脊髓麻醉完全恢復後24小時內，然而此併發症並不常見於硬脊膜外麻醉。我們提出一個腹部接受重大手術的年輕女性在接受硬脊膜外麻醉與止痛後發生暫時性神經症候群的病例，同時回顧其病因學、病理生理學、診斷準則以及治療方式。

關鍵字

硬脊膜外止痛 ； 利多卡因 ； 暫時性神經症候群

並列摘要

In 1993, the first reports of a new adverse effect defined as transient neurological symptoms (TNS), was described in patients recovering from spinal anesthesia with hyperbaric 5% lidocaine in the lithotomy position who postoperatively experienced aching and pain in the buttocks, thighs or lower extremities without associated with neurologic deficits or laboratory abnormalities. The symptoms can develop within 24 hours after a full recovery from ordinary uneventful spinal anesthesia. However, they are infrequently caused by lumbar epidural anesthesia and analgesia. We present a case of TNS caused by lumbar epidural anesthesia and analgesia in a young female adult receiving major abdominal surgery. We also review the etiology, pathophysiology, diagnostic criteria, and treatment of TNS.

並列關鍵字

epidural analgesia ； lidocaine ； transient neurological symptoms