[Paraplegia following removal of an epidural catheter].

IF 1.9 Q2 POLITICAL SCIENCE Regional-Anaesthesie Pub Date : 1991-08-01
W Klement, G Rothe, J Peters
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Abstract

Acute paraplegia caused by an epidural hematoma developed in a patient following the removal of an epidural catheter. This catheter had been used for 3 days for postoperative pain relief with no apparent complications. Heparin (10,000 units/day) had been infused for thrombosis prophylaxis and was associated with a normal activated partial thromboplastin time (aPTT) for the first two postoperative days. However, test results from blood drawn prior to catheter removal revealed, in retrospect, an unexpected prolongation of the aPTT (75 s) and PT (56%, Quick's method). An epidural hematoma extending from T12 to L4 was evacuated during emergency laminectomy and neurologic deficits resolved completely over the next days. Thus, the removal of an epidural catheter has the potential for inducing formation of an epidural hematoma. Accordingly, it may be safest to leave epidural catheters in place if test results demonstrate a bleeding diathesis or if a potential for bleeding is suspected on clinical grounds.

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[移除硬膜外导管后截瘫]。
病人在取出硬膜外导管后,因硬膜外血肿引起急性截瘫。该导管用于术后疼痛缓解3天,无明显并发症。肝素(10,000单位/天)输注用于血栓预防,并与术后前两天正常的活化部分凝血活素时间(aPTT)相关。然而,回想起来,拔管前抽血的测试结果显示,aPTT(75秒)和PT (56%, Quick的方法)出乎意料地延长。在紧急椎板切除术中,从T12到L4的硬膜外血肿被排出,神经功能缺损在接下来的几天内完全消除。因此,去除硬膜外导管有可能诱发硬膜外血肿的形成。因此,如果检查结果显示出血或临床怀疑有出血的可能,保留硬膜外导管可能是最安全的。
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CiteScore
3.50
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[An epidural spinal abscess as a lethal complication of peridural anesthesia]. [Knotting of a peridural catheter]. [A simple technique for estimating the level of analgesia in regional anesthesia]. [CSE--the combination of spinal and epidural anesthesia]. [Comments on the paper by R. Schürg et al. Maternal and neonatal plasma concentrations of bupivacaine during peridural anesthesia for cesarean section].
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