CASE REPORT
Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 284-286

Paraplegia following epidural analgesia: A potentially avoidable cause?


Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India

Correspondence Address:
Jeson R Doctor
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.130751

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Neurological deficit is an uncommon but catastrophic complication of epidural anesthesia. Epidural hematomas and abscesses are the most common causes of such neurological deficit. We report the case of a patient with renal cell carcinoma with lumbar vertebral metastasis who developed paraplegia after receiving thoracic epidural anesthesia for a nephrectomy. Subsequently, on histo-pathological examination of the laminectomy specimen, the patient was found to have previously undiagnosed thoracic vertebral metastases which led to a thoracic epidural hematoma. In addition, delayed reporting of symptoms of neurological deficit by the patient may have impacted his outcome. Careful pre-operative investigation, consideration to using alternative modalities of analgesia, detailed patient counseling and stringent monitoring of patients receiving central neuraxial blockade is essential to prevent such complications.


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