Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
Korean J Anesthesiol. 2011 Oct;61(4):336-40. doi: 10.4097/kjae.2011.61.4.336. Epub 2011 Oct 22.
We describe a case of acute lumbar epidural hematoma at the L2-3 level complicated by paraplegia, which occurred after coagulation disorder because of massive bleeding intraoperatively in cesarean section. The preoperative coagulation laboratory finding was in normal range and so we tried combined spinal epidural anesthesia. Uterine atony occurred in the operation, and there was persistant bleeding during and after the operation. After the operation, she complained of paresthesia on her both legs and was diagnosed with epidural hematoma (EDH) by radiologic examination. Emergency laminectomy on lumbar spine was carried out for hematoma evacuation and decompression of the epidural space at once. In our experience, massive bleeding during surgery may potentially increase the risk of EDH postoperatively.
我们描述了一例因剖宫产术中大量出血导致凝血功能障碍而并发 L2-3 水平急性腰椎硬脊膜外血肿和截瘫的病例。术前凝血实验室检查结果在正常范围内，因此我们尝试了联合脊髓硬膜外麻醉。手术中出现子宫收缩乏力，术中及术后持续出血。术后，她主诉双下肢麻木，经影像学检查诊断为硬脊膜外血肿（EDH）。立即行腰椎椎板切除术进行血肿清除和硬脊膜外腔减压。根据我们的经验，手术中大量出血可能会增加术后发生 EDH 的风险。
