Journal of Japan Society of Pain Clinicians
Online ISSN : 1884-1791
Print ISSN : 1340-4903
ISSN-L : 1340-4903
A case of intercostal hematoma discovered by thoracoscopy—a complication of thoracic epidural anesthesia
Yuka SAKUTATakeaki KONOMasako YAMAMOTOKyoichiro MAESHIMAYuichiro TODAHideki NAKATSUKA
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2020 Volume 27 Issue 1 Pages 91-94

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Abstract

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 Backflow of blood was observed when the catheter was inserted; hence, it was withdrawn.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.

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© 2020 Japan Society of Pain Clinicians
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