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Epidural hematoma after epidural anesthesia in a patient with peripheral vascular disease. Case report
G Martínez-Pallí1, X Sala-Blanch, E Salvadó
1Department of Anesthesiology, Reanimation, and Pain Therapy, Hospital Clínic i Provincial de Barcelona, Spain.
Background And Objectives:
Epidural hematoma is a severe, uncommon complication associated with epidural anesthesia in patients with peripheral vascular disease who require anticoagulant therapy.
Methods:
An 84-year-old woman with acute left leg arterial ischemia underwent revascularization surgery under lumbar epidural anesthesia. Pre- and postoperative heparin was administered as an anticoagulant.
Results:
Reperfusion of the leg was successful, however, 3 days later clinical signs of spinal cord compression appeared and epidural hematoma was diagnosed. Neurologic recovery was poor.
Conclusions:
This case highlights the need for careful individual preoperative analysis and postoperative observation to make anesthetic practice safe in patients receiving perioperative anticoagulant therapy.