Pereira Sofia, Nunes Sara, Luís Mariana
Department of Anesthesiology, Hospital Central do Funchal, Funchal, PRT.
Cureus. 2024 May 8;16(5):e59879. doi: 10.7759/cureus.59879. eCollection 2024 May.
Liver resection poses many challenges for the anesthesiologist, including intraoperative hemodynamic instability, postoperative pain, and risk of coagulopathy. We report a case of epidural hematoma after epidural catheter removal, following a minor liver single metastasectomy. The main purpose of this case report is to bring to light the false security provided by traditional coagulation parameters and whether further investigation should be considered in selected cases, before handling neuraxial catheters. Alterations in coagulation after a partial hepatectomy remain poorly understood; thus, we believe that additional hemostatic values such as viscoelastic testing might be considered to better assess these patients.
肝切除术给麻醉医生带来了诸多挑战,包括术中血流动力学不稳定、术后疼痛以及凝血病风险。我们报告一例在小范围肝脏单发性转移瘤切除术后拔除硬膜外导管后发生硬膜外血肿的病例。本病例报告的主要目的是揭示传统凝血参数所提供的虚假安全性,以及在处理神经轴导管之前,是否应在特定病例中考虑进一步检查。部分肝切除术后凝血功能的改变仍未得到充分了解;因此,我们认为或许可以考虑使用诸如粘弹性检测等额外的止血指标,以便更好地评估这些患者。