このエントリーをはてなブックマークに追加
ID 47562
file
title alternative
Transient Spinal Segmental Myoclonus during Neuraxial Anesthesia: A Report of Two Cases
creator
Tajima, Minoru
Moriwaki, Katsuyuki
Hashimoto, Ken
Fujii, Kiyoshi
Shiroyama, Kazuhisa
Sanuki, Mikako
Kurita, Shigeaki
subject
脊髄髄節性ミオクローヌス
脊髄幹麻酔
spinal segmental myoclonus
neuraxial analgesia
NDC
Medical sciences
abstract
We report here two cases of transient spinal segmental myoclonus occurred during neuraxial anesthesia. One case was an 82-year-old woman, who was scheduled to undergo surgery for abdominal aortic aneurism, was indwelled epidural catheter the day before surgery. A quick, involuntary muscle jerk of the lower limbs began 30 minutes after giving a test dose bolus injection of mepivacaine via the epidural catheter. Despite removal of the epidural catheter, the involuntary muscle jerk persisted and ceased spontaneously five hours after injection of mepivacaine. The other case was a 33-year-old woman who underwent an emergency Caesarean section under a combined spinalepidural anesthesia. Involuntary muscle jerk of the upper limbs began 76 minutes after the intrathecal administration of hyperbaric bupivacaine during immediate post-operative period. The involuntary muscle contraction ceased four hours after injection of bupivacaine without any treatment. In both cases, no abnormal findings were detected in the spinal cord in MRI and/or CT. The involuntary muscle jerk observed in those two patients was diagnosed spinal segmental myoclonus by neurologists. The unusual effect of local anesthetics to the spinal cord neurons during neuraxial anesthesia was suspected as the cause of myoclonus. Although the spinal myoclonus caused by neuraxial anesthesia is quite rare and its etiology is unclear, anesthesiologists should be aware of this bizarre and stressful complication.
description
本稿の要旨は日本麻酔科学会 中国・四国支部第50回学術集会(高松市,2013年)で発表した。
journal title
Ansesthesia and Resuscitation
volume
Volume 55
issue
Issue 1
start page
35
end page
38
date of issued
2019-03-01
publisher
広島麻酔医学会
issn
0385-1664
ncid
language
jpn
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
publisher
department
Graduate School of Biomedical & Health Sciences
他の一覧