The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Epidural Hematoma Following Continuous Epidural Analgesia in Patient Receiving Anticoagulant Therapy -A case report-

항응고제 사용 환자에서 지속적 경막외 제통술후 발생한 경막외 혈종 1예 -증례 보고-

  • Yoo, Kyung-Yeon (Department of Anesthesiology, Pain Clinic, College of Medicine, Chonnam National University) ;
  • Im, Woong-Mo (Department of Anesthesiology, Pain Clinic, College of Medicine, Chonnam National University) ;
  • Park, Joon-Seo (Department of Anesthesiology, Pain Clinic, College of Medicine, Chonnam National University)
  • 유경연 (전남대학교 의과대학 마취과학교실 및 통증치료실) ;
  • 임웅모 (전남대학교 의과대학 마취과학교실 및 통증치료실) ;
  • 박준서 (전남대학교 의과대학 마취과학교실 및 통증치료실)
  • Published : 1996.06.01
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Abstract

Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

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