2020 Volume 27 Issue 1 Pages 91-94
Intercostal hematoma is a rare complication of thoracic epidural anesthesia. However, it can have serious outcomes. We encountered a case of intercostal hematoma, which we believe developed by thoracic epidural procedure that damaged an intercostal blood vessel. The patient was a 50-year-old woman with a pulmonary tumor. Epidural anesthesia combined with general anesthesia was planned for partial resection of left upper lung by video-assisted thoracic surgery. An epidural puncture was made via the paramedian approach. Backflow of blood was observed when the catheter was inserted; hence, it was withdrawn. After changing the punctured level, catheter was successfully placed. At the end of the surgery, an intercostal hematoma was discovered by thoracoscopy. Although this is a rare complication, it can have serious outcomes. Physicians must take care of the direction of needle, when performing thoracic epidural anesthesia via the paramedian approach.
