RESUMEN
Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.
Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Anestesia Epidural , Aracnoides , Aracnoiditis , Bupivacaína , Cauda Equina , Cesárea , Isquemia , Lidocaína , Extremidad Inferior , Paraplejía , Periodo Posparto , Médula Espinal , Columna VertebralRESUMEN
We report a 62-year-old man who expired due to intraoperative stent thrombosis. He presented for radical cystectomy because of a bladder cancer. Before a surgery, coronary stent intervention was performed at left anterior descending (LAD) artery. And then he received dual antiplatelet medication for three weeks. Four weeks later, he had an operation for bladder cancer. During the surgery, arrhythmias were developed. After the surgery, the patient suffered from a ST segment elevation myocardial infarction, which was caused by total occlusion of the stent. Additional stent implantation was performed but immediately after the procedure, uncontrolled ventricular arrhythmias developed. It seems that patients with stents may be at heightened risk of stent occlusion during and after surgery. They should be required safe waiting period, titrated anticoagulatory therapy and exact monitoring of myocardial ischemia during the entire perioperative period.