A surgically placed epidural catheter in a patient with spinal trauma.
Can J Anaesth
; 45(2): 170-4, 1998 Feb.
Article
en En
| MEDLINE
| ID: mdl-9512854
ABSTRACT
PURPOSE:
To report the successful perioperative anaesthetic and analgesic management of a spinal trauma patient with a surgically placed epidural catheter. CLINICAL FEATURES A 15-yr-old adolescent woman sustained an unstable spinal column injury with an incomplete neurological deficit following a high speed motor vehicle accident. She was scheduled for spinal decompression and stabilisation through a left thoracoabdominal approach. Balanced general anaesthesia was undertaken. Prior to closure, a multi-orifice epidural catheter was surgically placed under direct vision 5 cm into the anterior epidural space. The catheter was then tunnelled out through the psoas muscle and secured in place. Combined epidural-general anaesthesia was then initiated for the duration of the case using 5 ml bupivacaine 0.25% after an initial test dose of 3 ml lidocaine 1.5% with epinephrine. An infusion of bupivacaine 0.10% and fentanyl 5 micrograms.ml-1 at 8 ml.hr-1 using patient controlled epidural analgesia (PCEA) provided excellent postoperative pain control for four days. She had an uncomplicated postoperative course.CONCLUSION:
A surgically placed epidural catheter provided excellent, safe, perioperative anaesthesia and analgesia in this patient with unstable spinal trauma.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
Problema de salud:
2_accidentes_transito
Asunto principal:
Dolor
/
Compresión de la Médula Espinal
/
Cateterismo
/
Analgesia Epidural
/
Anestesia Epidural
Límite:
Adolescent
/
Female
/
Humans
Idioma:
En
Revista:
Can J Anaesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
1998
Tipo del documento:
Article