Spinal hematoma after epidural catheter removal (case report) [Epidural kateter çekilmesi sonrasi spinal hematom]
Küçük Resim Yok
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
A 78-year old female patient with a diagnosis of gonarthrosis, was scheduled for total knee arthroplasty to the left knee under combined spinal and epidural anesthesia. In the lateral decubitus position an 18G Tuohy epidural needle was inserted through L4-5 interspace at the first attempt without any hemorrhagic complication and combined spinal and epidural anesthesia was applied. Since his routine laboratory test results were non-pathologic, his epidural catheter was withdrawn at the 48th postoperative hour. A second dose of low molecular weight heparin was given 1.5 hours after the removal of the catheter. Three hours after the removal of the catheter, severe lumbar and hip pain and paresthesia increasing with movements developed. Cardiovascular surgery was consulted because of development of edema in the operated leg. Doppler US, increase in the dosage of low molecular weight heparin, and 100 mg acety-lsalicylic acid for a putative acute deep venous thromboembolism were recommended. Magnetic resonance imaging obtained after intensification of postoperative lumbar and hip pains revealed an epidural hematoma at T 12-L2 level. The patient had to be taken to the operation room on the postoperative 90th hour when foot drop was developed, and drainage of the hematoma and laminectomy were performed. The patient was discharged from the hospital on the 15. postoperative day without any neurologic defect. In conclusion, subsequent to epidural catheter withdrawal noncompliant with ASRA (Association of Regional Anaesthesia) criteria and earlier anticoagulation, spinal hematoma developed Increase in the dosage of anticoagulation in consideration of deep vein thrombosis without proper consideration of differential diagnosis led to spinal hematoma with neurological findings.
Açıklama
Anahtar Kelimeler
Low molecular weight heparin, Spinal hematoma
Kaynak
Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
38
Sayı
2
