León-Álvarez É, Ramírez-Segura EH

Language: Spanish
References: 7
Page: 37-41
PDF size: 335.89 Kb.

ABSTRACT

A case report of paraplegia after thoracotomy under combined anesthesia (general anesthesia over epidural anesthesia) at the National Institute of Pediatrics. The paraplegia is described as a rare complication after thoracotomy rarer still secondary to epidural analgesia in adults and children. This is the second case reported in the literature. A male patient aged 14 with no history of prior importance to the current condition. He suffers an accident in the street after being hit on his bike by a car, without loss of alertness, getting direct trauma to the thoracic region, who is managed with analgesics and anti-inflammatories, then had a limited range for the march and dyspnea efforts. Study protocol is initiated and diagnosed with right thoracic hematoma which is scheduled for elective thoracoscopy drainage. In the immediate postoperative period, the patient reported numbness and inability to mobilize the lower segment of the body. At first instance the surgical team attributed this complication to the anesthetic technique. Subsequently the case is reviewed jointly with the department of neurosurgery who in the chest CT scan (performed prior to surgery) warns that there is an intrathoracic lesion at the level of T5-T6 which extends to T12-L1 and seems to invade the spinal canal. It begins the study protocol and the MRI shows a lesion occupying the spinal canal to the right side margin of T9-T12, which produces mass effect and shift to the left spinal cord, with severe edema at the site of the spinal cord compression. The patient was underwent surgically by the department of neurosurgery. The anesthetic technique was correct, and its implementation was not attributable to the postoperative complication. Anesthesiologists are encouraged to perform a proper pre-anesthetic assessment including physical examination and detailed review of laboratory and imaging tests.

REFERENCES

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