Epidural Emphysema After Placement of a Thoracic Epidural Catheter
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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).
KeywordsPneumorrhachis Epidural air Epidural emphysema Epidural pneumatosis Postdural puncture headache Intracranial hypertension Intracranial hypotension Loss of resistance to air
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