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Epidural Emphysema After Placement of a Thoracic Epidural Catheter

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Challenging Cases and Complication Management in Pain Medicine

Abstract

Epidural emphysema, a rare phenomenon, refers to the presence of air within the epidural space. Although usually considered benign when an isolated finding, epidural emphysema also may be a sign of a complicated and malignant disease process. There are many routes for air entry into the epidural space; one common route is during epidural placement for anesthesia with the loss of resistance to air technique. Most patients are asymptomatic, with no additional management indicated. In severe cases with neurological compromise, surgical decompression is required. Elevated inspired oxygen concentration and hyperbaric oxygen increase the resorption of air (Overdiek et al., J Clin Anesth 13:392–7, 2001).

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References

  1. Newbold R, Wiener M, Volger J. Traumatic pneumorrhachis. Am J Roentgenol. 1987;148:615–6.

    Article  CAS  Google Scholar 

  2. Schirmer C, Heilman C. Pneumocephalus: case illustrations and review. Neurocrit Care. 2010;13:152–8.

    Article  PubMed  Google Scholar 

  3. Oertel M, Reinges M. Pathogenesis, diagnosis and management of pneumorrhachis. Eur Spine J. 2006;15(5):S636–43.

    Article  Google Scholar 

  4. Cloran F, Bui-Mansfield LT. Extracranial epidural emphysema: pathway, aetiology, diagnosis and management. Br J Radiol. 2011;84(1002):570–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Ford LT, Gilula LA, Murphy WA, Gado M. Analysis of gas in vacuum lumbar disc. AJR Am J Roentgenol. 1977;128:1056–7.

    Article  CAS  PubMed  Google Scholar 

  6. International Headache Society. Post-dural (post-lumbar) puncture headache. IHS classification ICHD-II. 7.2.1. http://ihsclassification.org/en/02_classification/03_teil2/07.02.01_nonvascular.html. Accessed 1 Mar 2016.

  7. Overdiek N, Grisales D, Gravenstein D. Subdural air collection: a likely source of radicular pain after lumbar epidural. J Clin Anesth. 2001;13:392–7.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Dalia Elmofty M.D. .

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Rao, P., Elmofty, D. (2018). Epidural Emphysema After Placement of a Thoracic Epidural Catheter. In: Anitescu, M., Benzon, H., Wallace, M. (eds) Challenging Cases and Complication Management in Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-60072-7_52

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  • DOI: https://doi.org/10.1007/978-3-319-60072-7_52

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