施行硬脊膜外導管置入做為術後止痛意外合併硬脊膜外及硬脊膜下阻斷之病例報告

Combined Subdural and Epidural Block in a Case of Epidural Catheterization for Postoperative Analgesia

一位婦人在進行完開腹手術，為了緩解術後疼痛而接受硬脊膜外腔導管的置放；然而由於藥物輸注產生不尋常的臨床表現，在進一步作放射線學上的檢查之後，疑似因為導管的出口端同時存在於硬脊膜內外腔，因而產生了多樣非專一性的神經阻斷表現。

We report a case of unusual block caused by postoperative epidural analgesia for laparotomy in a gynecologic patient in consequence of inadvertent epidural catheterization. The clinical manifestation included agitation, spotty distribution of analgesia, wide spread of sensory block and loss of motor power. The radiological findings suggested a multicompartmental block with the anchorage of the catheter tip stretching over the epidural and subdural spaces. The default of catheter position was not detected during routine test dose procedure.