J Korean Pain Soc.  1998 May;11(1):165-168.

Epidural Abscess Following Continuous Epidural Analgesia in Patient with Ratient with Rectal Cancer

• Chang SH
• Koo EH
• Lim HJ
• Cho H
• Lee HW
• Yoon SM

Abstract

Although the incidence of epidural abscess is low, patient requiring continuous epidural analgesia for control of acute and chronic pain is increasing rapidly. Therefore we anticipate more frequent encounters with epidural abscess patients in future. Once epidural abscess formation begins, early diagnosis and treatment is very important to prevent permanent neurologic damage. The authors encountered a case of epidural abscess after continuous epidural analgesia for control of perineal pain due to rectal cancer. Forty-eight hours after the block, patient began to suffer severe low back pain, local tenderness, and fever. So the catheter was removed and culture sensitivity test was done with blood and local drainage. The test results identified methicillin susceptible staphylococcus aureus. Antibiotics were administered. Ten days after the block, left ankle jerk disappeared, and force of dorsiflexion of great toe decreased, but numbness or anesthesia appeared at L5 dermatome. aminectomy was performed, and abscess and necrotic fat material was removed from left L nerve root. The patient was discharged 12 days after operation without any neurologic sequalae.

Keyword

Anesthetic technique, epidural, catheterization, continuous; Complications, abscess; Pain, Cancer, rectal

MeSH Terms

Abscess
Analgesia, Epidural*
Anesthesia
Ankle
Anti-Bacterial Agents
Catheters
Chronic Pain
Drainage
Early Diagnosis
Epidural Abscess*
Fever
Humans
Hypesthesia
Incidence
Low Back Pain
Methicillin
Rectal Neoplasms*
Staphylococcus aureus
Toes
Anti-Bacterial Agents
Methicillin