title: Paraplegia after combined general and epidural anesthesia: a case report.
abstract: Neurological complications after epidural anesthesia performed for abdominal surgery are uncommon, but of important consequence with significant morbidity. Paraplegia is very rare and may be a result of multiple factors. We report a case of elective colectomy under combined general and epidural anesthesia for a carcinoma. An epidural infusion was used for intra-operative and post-operative analgesia. During induction of anesthesia, the patient was asystolic for a few seconds and during the first postoperative day, a hypotensive episode was registered. He then developed a sensory-motor deficit in the legs. A spinal cord infarction at the level of T10 extending to T2 was diagnosed with magnetic resonance imaging. The association of hypotension as a cause of spinal cord infarction is discussed. The factors that may have contributed to paraplegia and preventive neuroprotective strategies are reviewed.
authors.affiliation: Department of Anesthesiology, Hospital Saint-Luc, Catholic University of Louvain, Brussels, Belgium. gulcan.cekic@hcuge.ch
authors.forename: G
authors.initials: G
authors.lastname: Cekic
authors.forename: M
authors.initials: M
authors.lastname: De Kock
authors.forename: Y
authors.initials: Y
authors.lastname: Kremer
authors.forename: J L
authors.initials: JL
authors.lastname: Scholtes
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D003131:Combined Modality Therapy; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007238:Infarction / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D013116:Spinal Cord / Q000098:blood supply