title: [Lumbar plexopathy after abdominal hysterectomy: case report.].
abstract: OBJECTIVE
  Very often, neurological injuries diagnosed postoperatively are attributed to the anesthesia, but they can also be secondary to the surgery itself. The aim of this report was to present the case of a patient who underwent a pelvic surgery and developed lumbar plexopathy, and to discuss the possible causes.
  
  
  METHODS
  A woman patient, 38 years old, 58 kg, 1.63 m, physical status ASA I, was admitted to undergo a total abdominal hysterectomy for treatment of uterine leiomyomatosis. Initial monitoring included pulse oxymetry, non-invasive blood pressure, electrocardioscope, and urine output. After venous cannulation in the left upper limb with an 18G catheter, cefazoline (2 g), dypirone (2 g), dexamethasone (10 mg), and metochlopramide (10 mg) were administered. With the patient in left lateral decubitus, a 16G Tuohy needle was inserted in the L3-L4 space, in the median line, for the epidural block. Fifteen milliliters of 0.75% ropivacaine and 2 mg of morphine were administered, followed by placement of the catheter for postoperative analgesia. The surgery was uneventful, and the patient's cardiovascular parameters were stable. Eight hours after the procedure, at the postanesthetic follow-up, the patient could not walk and presented monoparesis in the left lower limb. The hypothesis of radicular syndrome was ruled out after clinical and radiological evaluation. Since symptoms did not resolve, an electroneuromyography was done 30 days later, and was compatible with lumbar plexopathy, which was possibly caused by trauma.
  
  
  CONCLUSIONS
  The anesthesiologist must be aware of the postoperative neurological complications and should be part of the efforts to diagnose their causes, of the treatment, and its evolution.
authors.affiliation: Departamento de Cirurgia Geral e Especializada, HUAP, UFF.
authors.forename: Elizabeth Vaz da
authors.initials: EV
authors.lastname: Silva
authors.forename: Marco Antonio Cardoso de
authors.initials: MA
authors.lastname: Resende
authors.forename: Alberto
authors.initials: A
authors.lastname: Pantoja
authors.forename: Adriana Barrozo Ribeiro Furuguem
authors.initials: AB
authors.lastname: Carvalho
authors.forename: Alexandre Barbosa da
authors.initials: AB
authors.lastname: Silva
authors.forename: Fabrício Azevedo
authors.initials: FA
authors.lastname: Cardoso