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산모에서 발생한 경막외 블록 후 하지 마비 -증례보고-

A Case of Paraplegia Associated with Epidural Anesthesia -A case report-

  • 김현혜 (울산대학교 의과대학 서울아산병원 마취통증의학교실) ;
  • 김두환 (울산대학교 의과대학 서울아산병원 마취통증의학교실) ;
  • 김성훈 (울산대학교 의과대학 서울아산병원 마취통증의학교실) ;
  • 임정길 (울산대학교 의과대학 서울아산병원 마취통증의학교실) ;
  • 이청 (을지대학교 의과대학 마취통증의학교실) ;
  • 신진우 (울산대학교 의과대학 서울아산병원 마취통증의학교실)
  • Kim, Hyun Hea (Department of Anesthesiology and Pain Management, Asan Medical Center, University of Ulsan College) ;
  • Kim, Doo Hwan (Department of Anesthesiology and Pain Management, Asan Medical Center, University of Ulsan College) ;
  • Kim, Sung Hoon (Department of Anesthesiology and Pain Management, Asan Medical Center, University of Ulsan College) ;
  • Leem, Jeong Gill (Department of Anesthesiology and Pain Management, Asan Medical Center, University of Ulsan College) ;
  • Lee, Cheong (Eulji University Hospital, Eulji University College of Medicine) ;
  • Shin, Jin Woo (Department of Anesthesiology and Pain Management, Asan Medical Center, University of Ulsan College)
  • 투고 : 2008.06.24
  • 심사 : 2008.07.30
  • 발행 : 2008.08.30

초록

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

키워드

참고문헌

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피인용 문헌

  1. Severe adhesive arachnoiditis resulting in progressive paraplegia following obstetric spinal anaesthesia: a case report and review vol.67, pp.12, 2012, https://doi.org/10.1111/anae.12017
  2. Unexplained episode of sensory-motor deficit following lumbar epidural analgesia vol.32, pp.1, 2019, https://doi.org/10.3344/kjp.2019.32.1.53
  3. Adhesive Arachnoiditis following Inadvertent Epidural Injection of 2% Chlorhexidine in 70% Alcohol-Partial Recovery over the Ensuing Eight Years vol.46, pp.6, 2008, https://doi.org/10.1177/0310057x1804600606