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KMID : 1155520200150040492
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Anesthesia and Pain Medicine
2020 Volume.15 No. 4 p.492 ~ p.497
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Pneumocephalus following fluoroscopy-guided lumbar epidural injection in elderly patients: two cases report and a review of Korean literatures - Two cases report -
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Park Sun-Kyung
Park Sang-Hyun
Lee Bang-Won
Cho Woo-Jin
Choi Yun-Suk
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Abstract
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Background: Pneumocephalus can originate from accidental dural puncture while performing epidural block using the loss-of-resistance (LOR) technique with an air-filled syringe.
Case: We present two cases of pneumocephalus after lumbar epidural block under fluoroscopy for pain control in elderly patients.
Conclusions: Lumbar epidural block should be performed under fluoroscopic guidance in elderly patients with severe lesions. The physician should be aware of the increased possibility of a dural puncture occurring due to anatomical changes in older patients. The use of saline is recommended for the LOR technique. A contrast injection should be used together with the LOR technique to locate the epidural space. If a dural puncture occur, the patient should be carefully monitored to determine whether pneumocephalus has developed.
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KEYWORD
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Back pain, Complications, Fluoroscopy, Headache, Pneumocephalus
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