短暂性麻痹时胸椎硬膜外血肿的识别:1例报告。

B. VanderWielen, L. Rubenstein, M. Shnider, Cindy M. Ku, Jason S. Wakakuwa
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引用次数: 0

摘要

一名71岁妇女,服用阿司匹林,行远端胰腺切除术、脾切除术和部分结肠切除术,术前放置T8/9硬膜外导管3次。术前给予预防性皮下肝素5000单位。术后第2天拔除导管后,患者出现一过性双侧下肢瘫痪,30分钟内几乎完全恢复。紧急MRI显示T4-T8硬膜外血肿,提示紧急T3-T8椎板切除术。本病例报告强调需要提高对接受未分割肝素预防血栓栓塞并发阿司匹林患者轴向镇痛相关并发症的认识。
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Recognition of a Thoracic Epidural Hematoma in the Setting of Transient Paralysis: A Case Report.
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use.
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