造成硬膜外腔麻醉時單側阻斷的原因－病例報告

ETIOLOGIES OF UNILATERAL BLOCK OF EPIDURAL ANESTHESIA: A CASE REPORT

洪至仁(Chih-Jen Hung)；左海生(Hai-Sen Tso)；葉子成(Tzu-Chen Yeh)

Acta Anaesthesiologica Sinica

28卷3期（1990 / 09 / 01）

371 - 372

繁體中文

硬膜外腔麻醉是一種相當常見且方便的麻醉方式，可是硬膜外腔麻醉有其一定的失敗率在教學醫院，這些失敗率往往是出自於經驗較少或正在學習的麻醉工作者；而我們却很少能對失敗的原因提出說明或檢討，而造成一些教學上的盲點，在此我們籍一個病例報告，來解釋某些盲點。

We would like to present a patient, who was a 60 years old man, 160 cm tall, weighing 55 kg, which received debridement for his pressure sores under epidural anesthesia. While inserting the Touhy needle, there was obvious loss of resistance at the level of 9 cm below the skin. When the test dose was injected, the compliance was good. Later, the anesthesia behaved as unilateral block. After the operation, the computerized tomography revealed the epidural catheter was between the facia of right psoas major muscle. Form this case, there were some lesions: (1) The distance from the skin to the lumbar dura mater is seldom longer than 7 cm. (2) The obvious loss-of-resistance and good compliance of test dose are not the guarantee of epidural anesthesia. (3) The psoas block may be another cause of unilateral block of lumbar epidural anesthesia.