여러 시험 방법으로 확인되지 않은 경막외 카테터의 혈관내 거치

• Published in: Korean journal of anesthesiology Vol. 53; no. 4; pp. 544 - 546
• Main Authors: 김영택, Young Taek Kim, 김신성, Sin Sung Kim, 류지근, Ji Keun Ryu, 정욱, Wook Jung
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회 30.10.2007
• Subjects: cesarean section; changing positions; epidural anesthesia; epinephrine; seizure; test dose; 마취과학
• ISSN: 2005-6419; 2005-7563

Epidural anesthesia for cesarean section allows the mother to be awake, minimizes or completely avoids the problem of maternal aspiration and neonatal drug depression from general anesthetics. But epidural anesthesia has the potential to produce local anesthetic systemic toxicity or inadvertent high spinal block which is due to unintentional administration of drug into an epidural vessel or subarachnoid space. There are several ways to avoid these complications. These include careful aspiration of epidural catheter, fractionation of the epidural dose, and the use of epinephrine containing epidural test dose before injection of epidural dose. We report a case of a pregnant woman who had developed a seizure after an injection of the epidural anesthetic. This occurred despite using the techniques of aspiration and epinephrine containing epidural test dose injection. So we thought that the seizure occurred probably by the migration of epidural catheter while changing positions and it should be considered in all cases of epidural anesthesia. (Korean J Anesthesiol 2007; 53: 544~6)