疑似骶管麻醉致左侧腓总神经损伤1例分析附文献复习  

Injury of the left common peroneal nerve caused by suspected sacral anesthesia:a case report and literature review

作　　者：彭惠翎 张桢 彭位俊 PENG Huiing;ZHANG Zhen;PENG Weijun(Graduate School,Hunan University of Chinese Medicine,Hunan,Changsha 410208,China;Department of Anorectal,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]湖南中医药大学研究生院,湖南长沙410208 [2]重庆市中医院肛肠科,重庆400021

出　　处：《中国医药科学》2024年第22期195-198,共4页China Medicine And Pharmacy

基　　金：重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0392)。

摘　　要：骶管麻醉是肛肠及会阴区域手术的常用麻醉方式。骶管麻醉虽有局部麻醉药物注射量大以及因骶管裂孔形态的个体差异大,易致麻醉效果有所差异等不足,但也因操作简便、中枢神经损伤风险程度低、麻醉范围局限且术中管理难度小,故在肛肠科手术中被广泛使用。骶管麻醉总体安全,发生麻醉后周围神经损伤并不多见。本文报道1例骶管麻醉下肛瘘手术患者术后出现左侧腓总神经支配区域感觉运动功能受损的病例;通过分析病例特点、诊治过程与治疗结果,分析出现左侧腓总神经支配区域感觉运动功能下降的可能原因,推测本例周围神经损伤为局部麻醉药物毒性引起的周围神经损害;结合文献复习,为今后临床中避免出现类似情况提供参考。Sacral canal anesthesia is a common anesthesia method for anorectal and perineal area surgery.Sacral canal anesthesia has shortcomings such as a large amount of local anesthetic injection and differences in anesthesia effectiveness due to individual differences in the shape of sacral canal hiatus.However,due to its simple operation,low risk of central nervous system injury,limited anesthesia range,and low difficulty in intraoperative management,it is widely used in colorectal surgery.Sacral anesthesia is generally safe,and peripheral nerve injury after anesthesia is rare.In this paper,a case of impaired sensory and motor function in the left common peroneal nerve control area after anal fistula surgery under sacral anesthesia is reported.By analyzing the characteristics of the case,the diagnosis and treatment process and the treatment results,the possible reasons for the decline of sensorimotor function in the left common peroneal nerve innervation area are analyzed,and it is speculated that the peripheral nerve injury in this case is caused by the toxicity of local anesthesia drugs.In addition,combined with the literature review,it provides reference for avoiding similar situations in clinic in the future.

关 键 词：骶管麻醉 腓总神经损伤 局部麻醉药物毒性损伤 周围神经损害 

分 类 号：R614[医药卫生—麻醉学]