Unilateral sensorimotor deficit caused by delayed lumbar epidural hematoma in a parturient after cesarean section under epidural anesthesia.

摘要

A 24-year-old parturient (weight 65 kg, height 160 cm) was scheduled for cesarean section under epidural anesthesia because of fetal breech position. The patient was healthy and was not taking any anticoagulatory drugs. Her preoperative platelet count, prothrombin time (PT), and activated partial thromboplastin time (aPTT) values were normal. The epidural anesthesia was performed in the midline of the Ll-2 interspace. A flexible catheter (SCW MEDICATH LTD, Shenzhen, China) was passed cephali-cally to a distance 4 cm beyond the tip of the needle. Aspiration through the catheter failed to yield blood or fluid. A test dose with 5 ml of 2 % lidocaine was administered. After 5 min, 12 ml of 2 % lidocaine was given for epidural anesthesia. The process of lumbar puncture and cesarean section was smooth and successful. The operation was finished within 1 h. Total estimated blood loss was 300 ml; 500 ml Gelofusine and 500 ml Ringer solution were administered. The epidural catheter was withdrawn after surgery.