rocuronium and Hematoma--Epidural--Spinal

Spontaneous spinal-epidural hematoma is uncommon and rare during pregnancy. We were presented with a 31-year-old patient who developed back pain with lower extremity paralysis at 36 weeks of gestation. A magnetic resonance imaging scan demonstrated an acute spinal-epidural hematoma and therefore, an emergency cesarean delivery was performed followed by hemilaminectomy with hematoma removal. Anesthesia was initiated with a volatile-based technique which, following delivery of the baby, was changed to target-controlled infusions of propofol and remifentanil. Postoperatively, dopamine was infused to maintain the blood pressure within the high-normal range to optimize spinal cord perfusion. Successful anesthetic and postoperative management is described together with a review of the literature.

Topics: Adult; Androstanols; Anesthesia; Anesthetics, Inhalation; Anesthetics, Intravenous; Back Pain; Cesarean Section; Dopamine; Emergency Treatment; Female; Follow-Up Studies; Hematoma, Epidural, Spinal; Humans; Laminectomy; Magnetic Resonance Imaging; Methyl Ethers; Neuromuscular Nondepolarizing Agents; Paraplegia; Piperidines; Pregnancy; Pregnancy Complications; Propofol; Remifentanil; Rocuronium; Sevoflurane; Treatment Outcome