title: Anesthetic management of a spontaneous spinal-epidural hematoma during pregnancy.
abstract: Spontaneous spinal-epidural hematoma is uncommon and rare during pregnancy. We were presented with a 31-year-old patient who developed back pain with lower extremity paralysis at 36 weeks of gestation. A magnetic resonance imaging scan demonstrated an acute spinal-epidural hematoma and therefore, an emergency cesarean delivery was performed followed by hemilaminectomy with hematoma removal. Anesthesia was initiated with a volatile-based technique which, following delivery of the baby, was changed to target-controlled infusions of propofol and remifentanil. Postoperatively, dopamine was infused to maintain the blood pressure within the high-normal range to optimize spinal cord perfusion. Successful anesthetic and postoperative management is described together with a review of the literature.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Jo
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.forename: Y J
authors.initials: YJ
authors.lastname: Chang
authors.forename: H J
authors.initials: HJ
authors.lastname: Kwak
mesh_terms: D000328:Adult; D000732:Androstanols; D000758:Anesthesia / Q000379:methods*; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001416:Back Pain / Q000209:etiology; D002585:Cesarean Section; D004298:Dopamine; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D046748:Hematoma, Epidural, Spinal / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D010264:Paraplegia / Q000209:etiology; D010880:Piperidines; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology / Q000601:surgery*; D015742:Propofol; D000077208:Remifentanil; D000077123:Rocuronium; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D000732:Androstanols; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D004298:Dopamine; D000077123:Rocuronium; D015742:Propofol