Epidural hematoma after epidural anesthesia in a patient with peripheral vascular disease. Case report.
OBJECTIVE
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.
Martínez-Pallí
G
G
Department of Anesthesiology, Reanimation, and Pain Therapy, Hospital Clínic i Provincial de Barcelona, Spain.
Sala-Blanch
X
X
Salvadó
E
E
Acosta
M
M
Nalda
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D004824:Epidural Space; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006406:Hematoma / Q000139:chemically induced* / Q000601:surgery; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007796:Laminectomy; D007866:Leg / Q000098:blood supply / Q000601:surgery; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000188:drug therapy; D017131:Thrombectomy
D000925:Anticoagulants; D006493:Heparin