Sudden motor and sensorial loss due to retroperitoneal hematoma during postoperative periods: a case report
| Autor: | Omer Ozel, Havva Gül Gültekin, İsmail Caymaz, Ayda Türköz, Pelin Şen |
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| Přispěvatelé: | ŞEN, PELİN, TÜRKÖZ, AYDA |
| Jazyk: | angličtina |
| Předmět: |
Anesthesia
Epidural Male medicine.medical_specialty Flaccid paralysis medicine.drug_class Epidural anesthesia Paralisia flácida lcsh:RD78.3-87.3 03 medical and health sciences 0302 clinical medicine Hematoma Lumbar Postoperative Complications 030202 anesthesiology Edema medicine Humans Paralysis Retroperitoneal Space Hematoma retroperitonial Anestesia peridural Aged Prostatectomy medicine.diagnostic_test business.industry Local anesthetic Magnetic resonance imaging General Medicine medicine.disease Surgery Retroperitoneal hematoma lcsh:Anesthesiology Anesthesia Abdominal ultrasonography Sensation Disorders medicine.symptom business Paraplegia 030217 neurology & neurosurgery |
| Zdroj: | Revista Brasileira de Anestesiologia, Vol 67, Iss 5, Pp 548-551 Revista Brasileira de Anestesiologia v.67 n.5 2017 Revista Brasileira de Anestesiologia Sociedade Brasileira de Anestesiologia (SBA) instacron:SBA Brazilian Journal of Anesthesiology, Vol 67, Iss 5, Pp 548-551 (2017) Revista Brasileira de Anestesiologia, Volume: 67, Issue: 5, Pages: 548-551, Published: OCT 2017 |
| Popis: | A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3–4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected. His thoracic/lumbar magnetic resonance imaging. Intraabdominal pressure was shown to be 25 mmHg, and abdominal ultrasonography revealed progression in the inflammation/edema/hematoma in the perirenal region. The Bromage score was back to 1 in the right foot on the 24th hour and in the left foot on the 26th hour. Paraplegia developed in patients after epidural infusion might be caused by potentiated local anesthetic effect due to retroperitoneal hematoma and/or elevated intra-abdominal pressure. Resumo: Paciente do sexo masculino, 68 anos de idade, hospitalizado para prostatectomia radical. O paciente não tinha história médica anormal, inclusive nem déficit neurológico antes da operação. Antes da anestesia geral, um cateter peridural foi inserido no espaço intermédio L3-4 para analgesia no intra e pós-operatório. Após a cirurgia que durou nove horas, o paciente desenvolveu confusão e paralisia flácida bilateral dos membros inferiores. Tomografia computadorizada de crânio e imagem de difusão por ressonância magnética não detectaram lesão. Os achados nas imagens de ressonância magnética torácica/lombar eram normais. A pressão intra-abdominal era de 25 mmHg e o ultrassom abdominal revelou progressão de inflamação/edema/hematoma na região perirrenal. O escore de Bromage voltou a 1 no pé direito na 24a hora e no pé esquerdo na 26a hora. A paraplegia desenvolvida nos pacientes após a infusão epidural pode ter sido causada por um efeito potencializado do anestésico local devido a hematoma retroperitoneal e/ou pressão intra-abdominal elevada. Keywords: Epidural anesthesia, Flaccid paralysis, Retroperitoneal hematoma, Palavras-chave: Anestesia peridural, Paralisia flácida, Hematoma retroperitonial |
| Databáze: | OpenAIRE |
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