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Large subcutaneous hematoma complicating epidural block.

Y Katz1, E Poppa, D C Segal

  • 1Department of Anesthesiology, Pain Management Service, HaEmek Medical Center, 18101 Afula, Israel. ykatz18@hotmail.com

Acta Anaesthesiologica Belgica
|April 27, 2002
PubMed
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A large lumbar subcutaneous hematoma occurred after epidural block for labor pain. This complication caused significant morbidity and prolonged hospitalization, highlighting a risk of neuroaxial blocks.

Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Surgical Complications

Background:

  • Epidural analgesia is commonly used for labor pain management in healthy primigravidas.
  • Neuroaxial blocks, including epidural anesthesia, carry potential risks and complications.
  • Subcutaneous hematoma formation is a recognized, though infrequent, complication of invasive procedures.

Observation:

  • A case of a large subcutaneous hematoma in the lumbar region following epidural block for labor pain relief is presented.
  • The patient, a young healthy primigravida, experienced bleeding around the epidural catheter site before an emergency cesarean section.
  • Postoperative imaging confirmed a significant lumbar subcutaneous hematoma.

Findings:

  • Coagulation and bleeding studies were within normal limits, suggesting the hematoma was not due to a primary bleeding disorder.

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  • The patient developed an unexplained fever postoperatively, requiring antibiotic treatment and extended hospitalization.
  • The subcutaneous hematoma was identified as a complication potentially linked to the epidural procedure.

    • Implications:

    • Subcutaneous hematoma formation after epidural block can lead to substantial patient morbidity.
    • This case suggests that lumbar subcutaneous hematoma should be considered among the potential complications of neuroaxial blocks.
    • Awareness and prompt recognition of such complications are crucial for effective patient management.