The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
권호 표지
DOI QR코드

DOI QR Code

Pneumocephalus Developed during Epidural Anesthesia for Combined Spinal-Epidural Anesthesia

척추경막외병용마취를 위한 경막외마취 중 발생한 기뇌증

  • Kim, Youn Jin (Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University) ;
  • Baik, Hee Jung (Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University) ;
  • Kim, Jong Hak (Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University) ;
  • Jun, Joo Hyun (Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University)
  • 김윤진 (이화여자대학교 의학전문대학원 마취통증의학교실) ;
  • 백희정 (이화여자대학교 의학전문대학원 마취통증의학교실) ;
  • 김종학 (이화여자대학교 의학전문대학원 마취통증의학교실) ;
  • 전주현 (이화여자대학교 의학전문대학원 마취통증의학교실)
  • Received : 2009.03.28
  • Accepted : 2009.06.19
  • Published : 2009.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

The superiority of air versus saline for identifying the epidural space remains unestablished. Epidural anesthesia using a loss of resistance technique (LORT) with air is associated with increasing complications of dural puncture-induced headaches and neurological and hemodynamic changes. Here, we described a case of pneumocephalus with a large amount of air that was accompanied by severe headache and nuchal and chest pain occurring after epidural block using LORT with air for combined spinal-epidural anesthesia.

Keywords

References

  1. Saberski LR, Kondamuri S, Osinubi OY: Identification of the epidural space: is loss of resistance to air a safe technique? A review of the complications related to the use of air, Reg Anesth 1997; 22: 3-15 https://doi.org/10.1016/S1098-7339(06)80050-7
  2. Shenouda PE, Cunningham BJ: Assessing the superiority of saline versus air for use in the epidural loss of resistance technique: a literature review. Reg Anesth Pain Med 2003; 28: 48-53 https://doi.org/10.1097/00115550-200309001-00085
  3. Han CS, Yu JS, Kim IH, Kim YJ, Kim CS, Ahn KR: Headache and pneumocephalus after lumbar epidural block: A case report. Korean J Pain 1996; 9: 251-5
  4. Fedder SL: Air ventriculogram serendipitously discovered after epidural anesthesia. Surg Neurol 1988; 30: 242-4 https://doi.org/10.1016/0090-3019(88)90280-7
  5. Harrell LE, Drake ME, Massey EW: Pneumocephaly from epidural anesthesia. South Med J 1983; 76: 399-400
  6. Taveras JM, Wood EH: Intracranial pneumography: morbidity and complications. In: Diagnostic neuroradiology. Edited by Taveras JM, Wood EH: Baltimore, Williams & Wilkins. 1964, pp 1248-66
  7. Katz Y, Markovits R, Rosenberg B: Pneumoencephalos after inadvertent intrathecal air injection during epidural block, Anesthesiology 1990; 73: 1277-9 https://doi.org/10.1097/00000542-199012000-00034
  8. Aida S, Taga K, Yamakura T, Endoh H, Shimoji K: Headache after attempted epidural block: the role of intrathecal air. Anesthesiology 1998; 88: 76-81 https://doi.org/10.1097/00000542-199801000-00014
  9. Ash KM, Cannon JE, Biehl DR: Pneumocephalus following attempted epidural anaesthesia. Can J Anaesth 1991; 38: 772-4 https://doi.org/10.1007/BF03008458
  10. Becker WJ: Pneumocephalus as a cause for headache, Can J Neurol Sci 2002; 29: 278-81 https://doi.org/10.1017/S0317167100002079
  11. Laviola S, KirvelTEX>$\ddot{a}$, M, Spoto MR, Tschuor S, Alon E: Pneumocephalus with intense headache and unilateral pupillary dilatation after accidental dural puncture during epidural anesthesia for cesarean section. Anesth Analg 1999; 88: 582-3 https://doi.org/10.1097/00000539-199903000-00022
  12. Abram S, Cherwenka RW: Transient headache immediately following epidural steroid injection. Anesthesiology 1979; 50: 461-2 https://doi.org/10.1097/00000542-197905000-00015
  13. Gonzalez-Carrasco FJ, Aguilar JL, Llubia C, Nogues S, Vidal-Lopez F: Pneumocephalus after accidenctal dural puncture during epidural anesthesia. Reg Anesth 1993; 18: 193-5
  14. Lucas DN, Kennedy A, Dob DP: Dural puncture and iatrogenic pneumocephalus with subsequent transverse myelitis in a parturient. Can J Anaesth 2000; 47: 1103-6 https://doi.org/10.1007/BF03027963

Cited by

  1. Pneumocephalus in a Patient with No Cerebrospinal Fluid Leakage after Lumbar Epidural Block - A Case Report - vol.25, pp.4, 2012, https://doi.org/10.3344/kjp.2012.25.4.262
  2. Pneumocephalus during labor analgesia using the combined spinal-epidural technique vol.65, pp.6 Suppl, 2013, https://doi.org/10.4097/kjae.2013.65.6S.S93
  3. Pneumocephalus associated with epidural and spinal anesthesia for labor vol.5, pp.5, 2015, https://doi.org/10.1212/CPJ.0000000000000178
  4. Post Dural Puncture Headache—Review and Suggested New Treatment vol.06, pp.09, 2016, https://doi.org/10.4236/ojanes.2016.69024
  5. Case Report: Pneumocephalus after labor epidural anesthesia vol.3, pp.None, 2014, https://doi.org/10.12688/f1000research.4693.1