• Tatsuya Katayama, Shinji Hirai, Yoshiharu Hamanaka, Takayuki Fukui, Shimon Itou, Shunzou Hatooka, and Tetsuya Mitsudomi.
• Department of Cardiovascular and Thoracic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
• Kyobu Geka. 2011 Nov 1;64(12):1071-5.

AbstractThe dual puncture is one of the diseaseful complications at the induction of the epidural anesthesia, which causes severe symptoms of intracranial hypotension such as headache and nausea. The clinical courses of 3 patients with the dual puncture symptoms after pulmonary resections were retrospectively reviewed, and the effect of the continuous epidural saline infusion treatment (CESI) for the dual puncture was evaluated. Pneumococcal empyema developed in 1 patient who had been treated with conservative management. In contrast, the symptoms of the others who were treated with the CESI were quickly recovered or were effectively prevented. This report strongly suggested that the CESI was convenient and effective treatment for dual punctune symptoms by suppressing the cerebrospinal fluid leakage by elevation of the fluid pressure in the extradural space.

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