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继发硬膜外麻醉后急性细菌性脑膜炎罕见,本文报道一例如下: 患者28岁,孕足月,住院日晨7_(AM)自然破水,晚7∶10_(PM)宫口开大5 cm,颈管完全消失,要求硬膜外麻醉。导管放入腰3～4间腔较顺利;未注药前见清亮脑脊液滴出,知误入蛛网膜下腔,经调整;导管位置正常;麻醉效果良好。住院一天后1∶44_(AM)自然分娩一男婴。分娩日上午产妇感轻微头痛;于坐及散步时加重。麻醉师考虑为脊髓液外溢之故;嘱卧床休息并输液。产后第一天头痛加重,麻醉师于10∶30_(AM)给自家血硬膜外注射;下午5时口表体温38.5℃;此刻无特殊主诉。体检及尿化验正常;白细胞达20,000。当日体温下降,头痛减轻,情况好转。产后第三天晨又感头项痛,1_(PM)
Acute bacterial meningitis secondary to epidural anesthesia is rare, this article reports a case as follows: 28-year-old patient, full term pregnancy, hospitalized morning 7 AM naturally broken water, night 7:10 PM (PM) cervix open 5 cm Neck completely disappeared, requiring epidural anesthesia. Catheter into the lumbar 3 to 4 cavity is smooth; no injection before see the clear cerebrospinal fluid drip, known to accidentally into the subarachnoid space, adjusted; catheter position is normal; anesthesia effect is good. One day after hospitalization, a baby boy is born spontaneously. Masturbation on the morning of a slight headache; increase when sitting and walking. Anesthesiologists consider the spill of spinal fluid; urge bed rest and infusion. The headache was aggravated on the first postnatal day. The anesthesiologist gave himself a blood epidural injection at 10:30 AM, and the body temperature was 38.5 ° C at 5 PM. There was no specific complaint at the moment. Physical examination and urine test normal; white blood cells up to 20,000. The day the temperature dropped, headache relief, the situation improved. On the third day postpartum, she felt headache again, 1_ (PM)