Korean J Anesthesiol.  1998 Nov;35(5):1023-1026. 10.4097/kjae.1998.35.5.1023.

Epidural Hematoma Following Lumbar Epidural Anesthesia: A case report

• Kim SH
• Kim YD

• KMID: 2240122
• DOI: http://doi.org/10.4097/kjae.1998.35.5.1023

Abstract

Epidural hematoma associated with epidural anesthesia is rare. We describe a case of a epidural hematoma after continuous epidural anesthesia and analgesia for arthroscopic patella shaving. Anesthesia was indudced with 8 ml lidocaine, 2.0% with epinephrine, 1:200,000 and surgery proceeded. When additional boluses of bupivacaine were administered later, aspiration of the epidural catheter still yielded no blood. At the end of the operation, an epidural infusion of 0.125% bupivacaine was done 2 ml/hr by two-day infusor. In the third postoperative day, the patient suffered from acute myocardial infarction and then heparin was infused. In the fourth postoperative day, she complained lumbar back pain and developed depressed dorsiflexion (Grade II) of great toe in left foot during the infusion of heparin. Sagittal MRI showed posterior thickened epidural hematoma along the segments of T12-L4. Despite the delayed laminectomy and decompression, which was performed six days after her initial operation, she had a good postoperative response, followed by a complete neurological recovery.

Keyword

Anesthetic technique: epidural; lumbar; Blood: heparin; Complications: epidural hematoma

MeSH Terms

Analgesia
Anesthesia
Anesthesia, Epidural*
Back Pain
Bupivacaine
Catheters
Decompression
Epinephrine
Foot
Hematoma*
Heparin
Humans
Infusion Pumps
Laminectomy
Lidocaine
Magnetic Resonance Imaging
Myocardial Infarction
Patella
Toes
Bupivacaine
Epinephrine
Heparin
Lidocaine