Paraplegia After Thoracic Epidural Steroid Injection

被引:5
作者
Loomba, Vivek [1 ]
Kaveeshvar, Hirsh [2 ]
Dwivedi, Samvid [1 ]
机构
[1] Henry Ford Hosp, Dept Anesthesiol, 2799 West Grand Blvd, Detroit, MI 48202 USA
[2] Henry Ford Hosp, Dept Neurol, Detroit, MI 48202 USA
关键词
D O I
10.1213/XAA.0000000000000402
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Epidural steroid injections are a common procedure performed by pain physicians. The American Society of Regional Anesthesia along with several other groups recently provided guidelines for performing epidural injections in the setting of anticoagulants. We present a case of a patient who developed an epidural hematoma and subsequent paraplegia despite strict adherence to these guidelines. Although new guidelines serve to direct practice, risks of devastating neurologic complications remain as evidenced by our case.
引用
收藏
页码:118 / 121
页数:4
相关论文
共 11 条
  • [1] The Risk and Outcomes of Epidural Hematomas After Perioperative and Obstetric Epidural Catheterization: A Report from the Multicenter Perioperative Outcomes Group Research Consortium
    Bateman, Brian T.
    Mhyre, Jill M.
    Ehrenfeld, Jesse
    Kheterpal, Sachin
    Abbey, Kenneth R.
    Argalious, Maged
    Berman, Mitchell F.
    St Jacques, Paul
    Levy, Warren
    Loeb, Robert G.
    Paganelli, William
    Smith, Kelly W.
    Wethington, Kevin L.
    Wax, David
    Pace, Nathan L.
    Tremper, Kevin
    Sandberg, Warren S.
    [J]. ANESTHESIA AND ANALGESIA, 2013, 116 (06) : 1380 - 1385
  • [2] Neurological deficits after epidural steroid injection: Time course, differential diagnoses, management, and prognosis suggested by review of case reports
    Bloodworth, Donna M.
    Perez-Toro, Marco R.
    Nouri, Kent H.
    [J]. PAIN MEDICINE, 2008, 9 : S41 - S57
  • [3] Oral anticoagulants and regional anesthesia: A perspective
    Enneking, FK
    Benzon, H
    [J]. REGIONAL ANESTHESIA AND PAIN MEDICINE, 1998, 23 (06): : 140 - 145
  • [4] Managing anticoagulated patients during neuraxial anaesthesia
    Green, Laura
    Machin, Samuel J.
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 2010, 149 (02) : 195 - 208
  • [5] Low molecular weight heparin: Biochemistry, pharmacology, perioperative prophylaxis regimens, and guidelines for regional anesthetic management
    Horlocker, TT
    Heit, JA
    [J]. ANESTHESIA AND ANALGESIA, 1997, 85 (04) : 874 - 885
  • [6] Spinal hematoma: a literature survey with meta-analysis of 613 patients
    D. Kreppel
    G. Antoniadis
    W. Seeling
    [J]. Neurosurgical Review, 2003, 26 (1) : 1 - 49
  • [7] Spinal haematoma after removal of a thoracic epidural catheter in a patient with coagulopathy resulting from unexpected vitamin K deficiency
    Ladha, A.
    Alam, A.
    Idestrup, C.
    Sawyer, J.
    Choi, S.
    [J]. ANAESTHESIA, 2013, 68 (08) : 856 - 860
  • [8] Manchikanti L, 2014, PAIN PHYSICIAN, V17, pE327
  • [9] Manchikanti L, 2012, PAIN PHYSICIAN, V15, pE969
  • [10] Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain
    Narouze, Samer
    Benzon, Honorio T.
    Provenzano, David A.
    Buvanendran, Asokumar
    De Andres, Jose
    Deer, Timothy R.
    Rauck, Richard
    Huntoon, Marc A.
    [J]. REGIONAL ANESTHESIA AND PAIN MEDICINE, 2015, 40 (03) : 182 - 212