1. [Risks and recommendations in Bechterew disease. Paraparesis after epidural anesthesia].
- Author
-
Allen D, Dahlgren N, and Nellgård B
- Subjects
- Aged, Aortic Aneurysm, Abdominal complications, Aortic Aneurysm, Abdominal surgery, Hematoma, Epidural, Cranial complications, Hematoma, Epidural, Cranial diagnosis, Humans, Magnetic Resonance Imaging, Male, Anesthesia, Epidural adverse effects, Hematoma, Epidural, Cranial etiology, Paraplegia etiology, Spondylitis, Ankylosing complications
- Abstract
We describe a case of paraparesis caused by an epidural haematoma in a 74-year-old man with advanced ankylosing spondylitis who received combined epidural and general anaesthesia for graft repair of an aneurysm of the abdominal aorta. Before the induction of general anaesthesia, an epidural catheter was inserted at the level of thoracic vertebrae 10-11 without difficulty or signs of bleeding. Total analgesia and paralysis of the legs in the early postoperative period raised suspicions of the presence of an epidural haematoma, which was confirmed by magnetic resonance tomography. Aspiration of the epidural catheter yielded 13 ml of blood. Despite early surgical decompression after transfer to a regional hospital, the patient remains paraparetic. We wish to highlight the risks of epidural anaesthesia in cases of ankylosing spondylitis, and to stress the need of routine control of motor function after epidural anaesthesia.
- Published
- 1997