肺癌手術患者における癒着性くも膜炎

Adhesive arachnoiditis is extremely rare, but it can have extremely serious neurologic sequelae. An 80-year-old man underwent right upper lobectomy under general anesthesia with epidural anesthesia for lung cancer. Paralysis of both lower limbs occurred from the day after surgery, and magnetic resonance imaging findings of syringomyelia appeared. Adhesive arachnoiditis was diagnosed, and vertebroplasty and arachnoid release were performed. A postoperative drug-induced lymphocyte stimulation test showed positive results for ropivacaine, which had been used for epidural anesthesia. Local allergy to this drug was therefore suspected as the cause of adhesive arachnoiditis.