경막외 차단술 후 발생한 감염 관련 합병증의 분석

Abstract

=An Analysis of Infection-Related Complications after Epidural BlockDae Hyun Jo, M.D., Ji Hee Hong, M.D., and Myuong Hee Kim, M.D.*Pain Clinic and *Department of Anesthesiology and Pain Medicine, Bundang CHA Medical Center,College of Medicine, Pochon Jung Moon University, Seongnam, KoreaBackground: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications.Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes.Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit.Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied. (Korean J Pain 2006; 19: 164 167)