경막외 마취 후 발생한 지속성 마미증후군 환자 1예 (A Case Report of Persistent Cauda Equina Syndrome Following Epidural Anesthesia)

서지정보

· 발행기관 : 대한근전도전기진단의학회
· 수록지 정보 : 대한근전도 전기진단의학회지 / 11권 / 2호 / 151 ~ 155페이지
· 저자명 : 정점순, 박기덕, 임오경

초록

Cauda equina syndrome (CES) is a rare complication of spinal and epidural anesthesia. We report a case
of persistent cauda equina syndrome after epidural anesthesia with single shot 0.5% bupivacaine. There
was no pain or paresthesia during needle placement or drug injection. 35-year-old woman experienced
pain and weakness in the both lower extremities and alterations in bowel and urinary habits after epidural
anesthesia for caesarean section. Electrodiagnostic examination revealed asymmetric bilateral lumbosacral
polyradiculopathies compatible with cauda equine syndrome. The patient MRI revealed arachnoiditis,
but did not show suspicious lesions such as hematoma and abscess. She was treated with medication,
bladder training and physical therapy, but her symptoms remained unchanged during a 2 year follow-
up. We suggest the chronic adhesive arachnoiditis resulting from bupivacaine neurotoxicity have
played a role in producing this devastating chronic complication.

영어초록

Cauda equina syndrome (CES) is a rare complication of spinal and epidural anesthesia. We report a case
of persistent cauda equina syndrome after epidural anesthesia with single shot 0.5% bupivacaine. There
was no pain or paresthesia during needle placement or drug injection. 35-year-old woman experienced
pain and weakness in the both lower extremities and alterations in bowel and urinary habits after epidural
anesthesia for caesarean section. Electrodiagnostic examination revealed asymmetric bilateral lumbosacral
polyradiculopathies compatible with cauda equine syndrome. The patient MRI revealed arachnoiditis,
but did not show suspicious lesions such as hematoma and abscess. She was treated with medication,
bladder training and physical therapy, but her symptoms remained unchanged during a 2 year follow-
up. We suggest the chronic adhesive arachnoiditis resulting from bupivacaine neurotoxicity have
played a role in producing this devastating chronic complication.

참고자료

· 없음