Postoperative epidural analgesia and possible transient anterior spinal artery syndrome.

Abstract

We present an unusual complication of epidural analgesia used to facilitate postoperative pain relief while allowing mobilization of the patient. A 65-year-old woman with a history of chronic obstructive pulmonary disease, atherosclerotic cardiovascular disease, chronic renal failure, and degenerative vertebral anatomy underwent resection of the left ureter due to obstructing tumor. The day following surgery, mobilization to an armchair was started, followed by a decrease in blood pressure. Soon after, flaccid paralysis with sparing of sensory functions, consistent with anterior spinal artery syndrome (ASAS), was diagnosed. This complication should be taken into account, especially in patients at risk, when considering epidural analgesia techniques in the postoperative period. Reg Anesth Pain Med 2001;26:274-277.