Rosen David A, Hawkinberry Denzil W, Rosen Kathleen R, Gustafson Robert A, Hogg Jeffery P, Broadman Lynn M
Departments of *Anesthesiology, †Pediatrics, ‡Surgery, and §Radiology, West Virginia University Children's Hospital, West Virginia University School of Medicine, Morgantown.
Anesth Analg. 2004 Apr;98(4):966-969. doi: 10.1213/01.ANE.0000103267.37895.5B.
An 18-yr-old patient had a thoracic epidural placed under general anesthesia preceding an uneventful aortic valve replacement with a bioprosthetic valve. On the second postoperative day, he was anticoagulated and also received an antithrombotic medication. While ambulating, he experienced pain in his back, and there was blood in his epidural catheter. The catheter was removed, and he developed motor and sensory loss. Rapid surgical decompression resulted in recovery of his lost neurological function. Management and strategies for preventing this problem are discussed.
Epidural hematoma is a rare complication of epidural anesthesia and has not been reported in pediatric patients undergoing cardiac surgery. The successful treatment of this complication requires swift recognition, diagnosis, and surgical intervention.
一名18岁患者在全身麻醉下进行了胸段硬膜外穿刺，随后顺利进行了生物人工瓣膜主动脉瓣置换术。术后第二天，他接受了抗凝治疗并同时服用抗血栓药物。在行走时，他感到背部疼痛，硬膜外导管中有血液。导管被拔除，他出现了运动和感觉丧失。快速手术减压使他丧失的神经功能得以恢复。文中讨论了预防该问题的管理方法和策略。
硬膜外血肿是硬膜外麻醉的一种罕见并发症，在接受心脏手术的儿科患者中尚未有报道。成功治疗该并发症需要迅速识别、诊断和手术干预。
