Challenges with two epidural catheters for labor analgesia in a patient with lumbar adhesions: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2024-06-18 DOI:10.1186/s40981-024-00724-1

Yuki Hosokawa, Rie Kato, Eriko Ohsugi, Michiko Sugita

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引用次数: 0

Abstract

Background: The efficacy of neuraxial analgesia varies with spinal canal pathology. Notably, a secondary epidural catheter has been shown to increase neuraxial labor analgesia in women with spinal lesions. Therefore, we present a case in which catheter withdrawal played a critical role in achieving effective labor analgesia in a woman with epidural adhesions after lumbar discectomy who had inadequate analgesia with two epidural catheters.

Case presentation: We encountered a patient with L5 lumbar epidural adhesions who reported pain even after receiving two epidural catheters. The catheters were placed in the L1/2 and L5/S intervertebral spaces. Analgesic effects were exerted when the L5/S catheter was withdrawn by 1 cm, suggesting that the catheter tip was initially placed inside the adhesion.

Conclusions: Careful consideration of catheter placement and adjustments by withdrawing the catheter are crucial in managing labor analgesia in patients with known epidural adhesions.

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腰椎粘连患者使用两种硬膜外导管分娩镇痛的挑战：病例报告。

背景：神经镇痛的效果因椎管病变而异。值得注意的是，在脊柱病变的产妇中，二次硬膜外导管已被证明可增加神经镇痛的效果。因此，我们介绍了一例腰椎间盘切除术后硬膜外粘连的产妇，在使用两根硬膜外导管镇痛不足的情况下，导管撤出在实现有效分娩镇痛方面发挥了关键作用：我们遇到了一名腰椎间盘切除术后硬膜外粘连的患者，她在使用了两根硬膜外导管后仍报告疼痛。导管分别置入 L1/2 和 L5/S 椎间隙。当将 L5/S 导管抽出 1 厘米时，镇痛效果显现，这表明导管尖端最初位于粘连处内部：结论：在管理已知硬膜外粘连患者的分娩镇痛时，仔细考虑导管放置位置并通过抽出导管进行调整至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.