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Acta Anaesthesiol Belg · Jan 2008
Case ReportsParaplegia after combined general and epidural anesthesia: a case report.
- G Cekic, M De Kock, Y Kremer, and J L Scholtes.
- Department of Anesthesiology, Hospital Saint-Luc, Catholic University of Louvain, Brussels, Belgium. gulcan.cekic@hcuge.ch
- Acta Anaesthesiol Belg. 2008 Jan 1;59(2):95-8.
AbstractNeurological complications after epidural anesthesia performed for abdominal surgery are uncommon, but of important consequence with significant morbidity. Paraplegia is very rare and may be a result of multiple factors. We report a case of elective colectomy under combined general and epidural anesthesia for a carcinoma. An epidural infusion was used for intra-operative and post-operative analgesia. During induction of anesthesia, the patient was asystolic for a few seconds and during the first postoperative day, a hypotensive episode was registered. He then developed a sensory-motor deficit in the legs. A spinal cord infarction at the level of T10 extending to T2 was diagnosed with magnetic resonance imaging. The association of hypotension as a cause of spinal cord infarction is discussed. The factors that may have contributed to paraplegia and preventive neuroprotective strategies are reviewed.
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