BACKGROUND: 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.
Abscess ; Anti-Bacterial Agents ; Arachnoid ; Arachnoiditis ; Catheterization ; Catheters ; Catheters, Indwelling ; Diabetes Mellitus ; Early Diagnosis ; Epidural Abscess ; Humans ; Laminectomy ; Meningitis, Aseptic ; Meningitis, Bacterial ; Patient Education as Topic ; Risk Factors

In general, coronary steal is defined as a fall in blood flow toward a certain vascular region in favor of another area during arteriolar vasodilatation. The coronary artery fistulae is an unusual abnormality in the general population, but is the most common abnormality of the coronary arteries that are ED: Either the ARTERIES ARE hemodynamically significant, or the ABNORMALITY IS hemodynamically significant. Hemodynamically significant. We experienced a 58-year-old male patient with intermittent chest pain at rest. Coronary angiography showed coronary artery fistulae on the LCX and RCA and retrograde flow from the LAD to LCX. Retrograde flow caused coronary artery steal syndrome on LAD territory. A stress/rest MIBI myocardial scan showed reversible ischemia on the LAD territory. He underwent an operation for the coronary artery fistulae, and has since been doing well without chest pain.
Arteries* ; Arteriovenous Fistula* ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Fistula ; Humans ; Ischemia ; Male ; Middle Aged ; Vasodilation