covid
Buscar en
Angiología
Toda la web
Inicio Angiología Anticoagulación perioperatoria y hematoma epidural. Caso clínico
Información de la revista
Vol. 52. Núm. 5.
Páginas 189-194 (enero 1999)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 52. Núm. 5.
Páginas 189-194 (enero 1999)
Acceso a texto completo
Anticoagulación perioperatoria y hematoma epidural. Caso clínico
Perioperative anticoagulation and epidural hematoma. Case report
Visitas
3212
Susana Cáncer Pérez, José R. March García, Alicia Bueno Bertomeu, Jesús Alfayate García, Rafael Ros Vidal
Francisco Acín García
Servicio de Angiología y Cirugía Vascular (Jefe de Servicio: Dr. Francisco Acín García), Hospital Universitario de Getafe Madrid (España)
Este artículo ha recibido
Información del artículo
Resumen

La aparición de un hematoma epidural es una complicación grave y muy poco frecuente de la anestesia epidural. Presentamos el caso de un varón de 90 años, que fue intervenido quirúrgicamente bajo anestesia epidural por cuadro de isquemia aguda en miembro inferior izquierdo. En el perioperatoria fue tratado con antiagregantes, anticoagulantes y fibrinolíticos. A las 24 horas de la cirugía, presentó hematoma epidural y paraplejía, a pesar de respetarse las pautas recomendadas respecto al uso de anticoagulación perioperatoria y anestesia locoregional.

Palabras clave:
Anestesia epidural
anticoagulación
hematoma epidural
Summary

The epidural hematoma development, is a very rare and severe complication after epidural anesthesia. We present a 90 year old man, operated with epidural anesthesia because he suffered from acute isquemia of left leg. He was treated during the perioperative period with antiplatelet, anticoagulant and thrombolytic agents. twenty-four hours after surgery he developed an epidural hematoma and paraplegia though all rules for perioperative anticoagulation and regional anesthesia were respected.

Key words:
Epidural anesthesia
anticoagulant
epidural hematoma
El Texto completo está disponible en PDF
Bibliografia
[1.]
Tryba M..
RüCkenmarksnahe regionalanäSthesie Und Niedermolekulare Heparine: Pro. AnäSthesiol. Intensivmed. Notfallmed.
Schemerzther, 28 (1993), pp. 179-181
[2.]
Vandermeuien E.P., Aken H.V., Vermylen J..
Anticoagulants And Spinal-epidural Anesthesia.
Anesth. Analg., 79 (1994), pp. 1165-1177
[3.]
Owens E.L., Kasten G.W., Hessel E.A..
Spinal Subarachnoid Hematoma After Lumbar Puncture And Heparinization: A Case Report, Review Of Literature, And Discussion Of Anesthetic Implications.
Anesth. Analg., 65 (1986), pp. 1201-1207
[4.]
Dickman C.A., Shedd S.A., Spetzler R.F., Shetter A.G., Sonntag V.K.H..
Spinal Epidural Hematoma Associated With Epidural Anesthesia: Complicatios Of Systemic Heparinization In Patients Receiving Peripheral Vascular Thrombolytic Therapy.
Anesthesiology, 72 (1990), pp. 947-949
[5.]
OnishchuK J.L., Carlsson C..
Epidural Hematoma Associated With Epidural Anesthesia: Complications Of Anticoagulant Therapy.
Anesthesiology, 77 (1992), pp. 1221-1223
[6.]
Horlocker T..
When to remove a spinal or epidural catheter in an anticoagulated patient.
Reg. Anesth., 18 (1993), pp. 264-265
[7.]
Rao T.L.K., El-Etr A.A..
Anticoagulation Following Placement Of Epidural And Subaracnoid Catheters: An Evaluation Of Neurologic Sequelae.
Anesthesiology, 55 (1981), pp. 618-620
[8.]
Comerota A.K., Rao R.C., Throm Skibinski C.I., Beck G.J., Ghosh S., Sun L., Curl G.R., Ricotta J.J., Graor R.A., Flinn W.C., Roedersheimer R.L., Alexander J.B..
A Prospective, randomized, blinded and placebo-controlled trial of intraoperative intra-arterial urokinase infusion during lower extremity revascularization. regional and Systemic Effects.
Annals of surgery, 218 (1993), pp. 534-543
[9.]
Cotton L.T., Flute P.T., Tsapogas M.J.C..
Popliteal Artery Thrombosis Treated With Streptokinase.
Lancet, 2 (1962), pp. 1081-1083
[10.]
Quiñones-Baldrich W.J., Zierler R.E., Hiatt J.C..
Intraoperative fibrinolytic therapy: an adjunt to catheter thromboembolectomy.
J. Vasc Surg., 2 (1985), pp. 319-326
[11.]
Cohen L.H., Kaplan M., Berhard V.M..
Intraoperative Streptokinase.
Arch. Surg., 121 (1986), pp. 708-715
[12.]
Norem R.F., Short D.H., Kerstein M.D..
Role Of Intraoperative fibrinolytic therapy in acute arterial occlusion.
Surg. Gyn. Obst., 167 (1988), pp. 87-91
[13.]
Comerota A.J., White J.V., Grosh J.D..
Intraoperative intra-arterial thrombolytic therapy for salvage of limbs in patients with distal arterial thrombosis.
Surg. Gyn. Obst., 169 (1989), pp. 283-289
[14.]
Quiñones-Baldrich W.J., Baker J.D., Busuttil R.W., Machleder H.I., Moore W.S..
Intraoperative infusion of lytic drugs for thrombotic complications of revascularization.
J. Vasc Surg., 10 (1989), pp. 408-417
[15.]
Parent F.N., Bernhard V.M., Pabst T.S., Mcintyre K.E., hunter G.C., Malone J.M..
Fibrinolytic treatment Of residual thrombus after catheter embolectomy for severe lower limb ischemia.
J. Vasc Surg., 9 (1989), pp. 153-160
[16.]
García R., Saroyan R.M., Senkowsky J., Smith F., Kerstein M..
Intraoperative intra-arterial urokinase infusion as an adjunt to fogarty catheter embolectomy in acute arterial occlusion.
Surg. Gyn. Obst., 171 (1990), pp. 201-205
[17.]
Comerota A.J., White J.V..
Intraoperative, intraarterial thrombolytic therapy as an adjunt to revascularization in patients With residual and distal arterial thrombus.
Sem. Vasc. Surg., 5 (1992), pp. 110-117
[18.]
Knaus J., RIS H.B., DO D., Sttrnemann P..
Intraoperative catheter thrombolysis as an adjunt to surgical revascularisation for infrainguinal limb-threatening ischaemia.
Eur. J. Vasc. Surg., 7 (1993), pp. 507-512
[19.]
Wasselle J.A., Bandyk D.F..
Intraoperative thrombolysis in peripheral arterial occlusion.
Jcc, 36 (1993), pp. 354-358
[20.]
Beard J.D., Nyamekye I., Earnshaw J.J., Scott D.J.A., Thomson J.F..
Intraoperative Streptokinase: a useful adjunt to ballon-catheter embolectomy.
Br. J. Surg., 80 (1993), pp. 21-24
[21.]
González-Fajardo J.A., Pérez-Burkhardt J.L., Mateo A.M..
Intraoperative fibrinolytic therapy for salvage of limbs with acute arterial ischemia: an adjunct to thromboembolectomy.
Ann. Vasc. Surg., 9 (1995), pp. 179-186
[22.]
Martínez-Pallí G., Sala-Blanch X., Salvadó E., Acosta M., Nalda M.A..
epidural hematoma after anesthesia in a patient with peripheal vascular disease. case report.
Reg. Anesth., 21 (1996), pp. 342-346
Copyright © 2000. SEACV
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos