在神经轴阻塞后的头骨神经
Mete Manici1, Rafet Onur Görgülü1, Kamil Darçın1
1Department of Anesthesiology and Reanimation, Koç University Hospital, İstanbul, Türkiye.
概括
神经是脊髓麻醉的罕见并发症,通常与脑脊液压力变化有关. 早期识别和治疗是麻醉后管理这些神经缺陷的关键.
科学领域:
- 神经学 神经学
- 麻醉学 麻醉学
背景情况:
- 脊柱麻醉是全球常见的区域麻醉技术.
- 神经是一种罕见但已报告的中枢神经轴阻的并发症.
- 内低血压是神经轴手术后神经麻的最常见原因.
研究的目的:
- 审查在脊髓和外周麻醉后脑神经麻的现有文献.
- 分析这些麻的发病率,受影响的神经,症状和潜在机制.
主要方法:
- 在PubMed和Google Scholar上对1952年至2023年的英语文章进行了全面的文献搜索.
- 搜索术语包括特定的头骨神经和麻醉技术 (脊柱,外围,硬膜穿刺).
- 分析了89篇文章和案例报告,对105个案件进行了审查.
主要成果:
- 神经在产科和妇科患者中更为频繁.
- 第六个神经 (abducens) 是最常见的报告,其次是第三个 (oculomotor).
- 双是第三,第四和第六神经麻的主要症状;第八神经麻的听力损失. 疼痛后的刺痛头痛 (PDPH) 经常与此相关.
结论:
- 在脊髓/外皮麻醉后最常见的神经损伤是第6和第3神经,主要归因于脑脊液 (CSF) 压力变化.
- 早期识别症状和适当的诊断方法对于有效治疗至关重要.
- 治疗策略应根据CSF压力变化的潜在机制量身定制.
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