硬膜外カテーテルの結節形成により抜去困難をきたした1症例 A Case of Difficulty in Removing an Epidural Catheter due to Formation of Knots

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硬膜外麻酔の合併症の一つにカテーテル抜去困難があるが,カテーテルの結節形成により抜去困難をきたす症例は非常に少ない.<br>症例は21歳,男性.右大腿骨骨折に対し観血的骨接合術が予定された.L3-4より硬膜外穿刺し,カテーテルを留置した.カテーテル挿入時は神経学的異常を認めず,術後のブロック効果も問題なかった.翌日,主治医がカテーテル抜去を試みたが,不能であった.カテーテル造影で皮下での結節形成が疑われたため,局麻下に切開しカテーテルを抜去した.カテーテル先端部で結節形成を認めた.<br>皮下などの浅い位置での結節形成が疑われる場合は,感染の危険性や患者の不安を考慮し,早期に外科的摘出を施行すべきである.

Difficulty in removing catheter is one of the complications of epidural anesthesia, but it is very rare that it is caused by the formation knots in a catheter. A 21-year-old man was prepared for an operation on a femoral fracture. Epidural puncture was performed between L3 and L4. During the catheter insertion there was no sign of neurological incidence and postoperative epidural analgesia was sufficient. The next day, a surgeon tried to extract the catheter but could not. X-ray examination with a contrast showed the tip of the catheter located 3cm under the skin surface, then the catheter was drawn out under local infiltration anesthesia. A knot was found to have formed on the tip of the catheter.<br>In the case that X-ray examination shows a suspicion of knots forming in a catheter in shallow tissue, considering the possibility of infection and patient anxiety, a surgical procedure should be done as soon as possible.

収録刊行物

  • 日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia 21(7), 395-398, 2001-09-15

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA

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各種コード

  • NII論文ID(NAID)
    10010154797
  • NII書誌ID(NCID)
    AN00330159
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    02854945
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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