[脊柱针断裂:临床病例和文献简评]。

José Francisco Camacho-Aguilera, Luis Martínez-Copado, Carmen Dalia Jiménez-Ramos
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引用次数: 0

摘要

背景:脊髓麻醉可能出现各种并发症,其中之一是脊髓针头在鞘内间隙断裂,这是最少见的并发症之一,但可能很严重。本文介绍了一例脊髓针破损病例,指出了其风险因素,并提出了减少风险的建议:临床病例:5 岁女患者,计划取出导致慢性疼痛的移位宫内节育器。在尝试脊髓麻醉时,针头上的针眼被拔出并进入蛛网膜下腔。拔出时,脊髓针变形并缩短。在透视和局部麻醉下,断裂的碎片被立即取出,没有出现并发症。区域麻醉被广泛用于孕妇,因为它被认为是安全的。然而,有些因素(肥胖、怀孕、紧急手术、脊髓针操作不当等)会增加脊髓针断裂的几率。即便如此,仍有各种建议(使用超声波、正确处理针头、减少尝试次数等)可以降低脊柱穿刺针断裂的风险:结论:应找出脊柱穿刺针断裂的风险因素,以降低其发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Broken spinal needle: Clinical case and a brief review of the literature].

Background: Spinal anesthesia can present various complications, one of which is the breakage of a spinal needle within the intrathecal space, which is one of the least frequent complications and it may be serious. A case of spinal needle breakage is presented, pointing out its risk factors and recommendations to reduce it.

Clinical case: 5-year-old female patient, who was scheduled for removal of translocated intrauterine device causing chronic pain. When attempting a spinal anesthesia, stylet was removed from the needle and directed into the subarachnoid space. Upon extraction, the spinal needle was deformed and shortened. Immediately and with fluoroscopy and local anesthesia, the broken fragment was extracted without complications. Regional anesthesia is widely used in pregnant women, as it is considered safe. However, there are factors that increase the probability of a spinal needle breakage (obesity, pregnancy, emergency procedures, incorrect handling of the spinal needle, etc.). Even so, there are various recommendations (use of ultrasound, proper handling of the needle, reducing the number of attempts, etc.) that can reduce the risk of spinal needle breakage.

Conclusion: Risk factors for spinal needle breakage should be identified, in order to decrease its incidence.

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