[Conservative treatment of hematoma after spinal anesthesia: case report and literature review.].
OBJECTIVE
Spinal anesthesia caries the risk of bleeding. Compression of nervous tissue secondary to the formation of a hematoma can cause neurological damage, which, if not diagnosed and treated in a timely fashion, can be permanent. The identification of risk factors, diagnosis, and early treatment are important for the prognosis. The objective of this report was to describe the case of a hematoma after spinal anesthesia treated conservatively, and review the literature.


METHODS
Male patient, 73 years old, 65 kg, 1.67 m, and ASA physical status III, underwent spinal anesthesia for removal of a peritoneal dialysis catheter. During the puncture, the patient experienced paresthesia of the right lower limb. Fifteen milligrams of 0.5% hyperbaric bupivacaine without vasoconstrictor were administered. Twenty-four hours later, saddle anesthesia and lumbar pain persisted and, after 48 hours, the patient presented urinary incontinence. An MRI demonstrated the presence of an expansive subarachnoid process compressing the nerve roots (L4 and S1). After evaluation by the neurosurgeon, conservative treatment was instituted. The patient was discharged from the hospital on the 18th postoperative day, asymptomatic.


CONCLUSIONS
The case reported here presented a good evolution with the conservative treatment.
Segabinazzi
Daniel
D
FFCMPA.
Brescianini
Betina Comiran
BC
Schneider
Felipe Gornicki
FG
Mendes
Florentino Fernandes
FF