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Revista Brasileira de Anestesiologia

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Abstract

SILVA, Ranger Cavalcante da; MORAIS E SILVA, André; LAFFITTE, Fernando Santos  and  JAMUS, Gilbert. Epidural hematoma after general anesthesia associated with postoperative analgesia with epidural catheter in patient using low molecular weight heparin: case report. Rev. Bras. Anestesiol. [online]. 2006, vol.56, n.2, pp. 174-182. ISSN 0034-7094.  http://dx.doi.org/10.1590/S0034-70942006000200009.

BACKGROUND AND OBJECTIVES: Presents a patient case with epidural hematoma, in the course of the use of epidural catheter and low molecular weight heparin, her clinical condition and treatment. CASE REPORT: A 75-year old female patient, submitted to the fixation of lumbar spine by anterior route, who, in the postoperative period, developed a clinical condition of progressive paralysis of the lower limbs, with loss of sensitivity and presenting no intense radicular pain. The treatment was the immediate medullar decompression, with drainage and surgical cleaning of a epidural hematoma, which extended from the 5th to the 10th thoracic vertebrae. After the drainage of the hematoma, the patient gradually recovered the strength in the lower limbs, was discharged in ten days with a condition of sphincterian dysfunction. After three months, the condition receded and there was no definitive neurological sequel. CONCLUSIONS: The quick diagnosis with early surgical intervention is the most effective treatment for the reduction of neurological damage, in patients that develop postoperative epidural hematoma. The use of low molecular weight heparin, in the course of the use of epidural catheter, requires the strict compliance with the established protocols so that the risks of epidural hematoma development can be reduced.

Keywords : ANESTHETIC TECHNIQUES, Regional [continuous epidural]; COMPLICATIONS [epidural hematoma]; DRUGS [fractioned heparin].

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