Spinal Epidural Hematoma Following Combined Spinal Epidural Anesthesia: A Case Report

A spinal epidural hematoma (SEH) is a rare complication of combined spinal epidural anesthesia. The case of a 55-year-old man who underwent orthopedic surgery under combined spinal epidural anesthesia is presented. Flurbiprofen and horse chestnut seed extract that potentially affect coagulation function during the perioperative period were used. The patient developed an SEH, but had normal coagulation function. Due to masking of neurologic symptoms by pain at the surgical site, the diagnosis of the SEH by magnetic resonance imaging was not made until postoperative day 9. Conservative treatment resulted in complete resolution of the SEH. Early, meticulous, and frequent neurologic examinations by anesthesiologists, surgeons, and nurses are crucial in preventing the delayed diagnosis of SEHs.