Acute cerebral infarction in a patient with an epidural catheter after left upper lobectomy: a case report

BMC Anesthesiology
Asuka KitajimaMasamitsu Sanui

Abstract

There are several recent reports that left upper lobe lung resection is a risk factor for the development of postoperative thromboembolism. Although administering epidural analgesia is common in thoracic surgery, anesthesiologists should be alert when administering epidural analgesia to a patient undergoing left upper lobectomy, considering the increased risk of postoperative thromboembolism and the potential need for anticoagulation or fibrinolytic therapy in the immediate postoperative period. A seventy-one-year-old female with a metastatic lung lesion developed a cerebral infarction approximately 30 h after video-assisted thoracoscopic left upper lobectomy. Cerebral intravascular therapy was indicated and the epidural catheter was removed immediately to avoid formation of an epidural hematoma. Approximately four hours after onset, reperfusion was successfully established by aspiration of endovascular thrombi. She recovered with mild residual paralysis of the left upper extremity and was transferred to a rehabilitation facility. We present a patient with a cerebral infarction after left upper lobectomy. Left upper lobectomy is associated with an increased risk of postoperative thromboembolism. Although the exact mechanism of ...Continue Reading

References

Nov 7, 2003·Anaesthesia and Intensive Care·V L ChadwickB G Fleming
Apr 30, 2013·The Annals of Thoracic Surgery·Kazuto OhtakaYoshiro Matsui
Sep 19, 2014·Journal of Cardiothoracic Surgery·Kazuto OhtakaYoshiro Matsui
May 26, 2015·Anaesthesia Critical Care & Pain Medicine·Matthieu JabaudonJean-Michel Constantin
Aug 15, 2015·Surgery Today·Takayoshi YamamotoIchiro Yoshino
Sep 25, 2017·Stroke; a Journal of Cerebral Circulation·Nicolas VoelkelGordian Jan Hubert

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Citations

Jan 23, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Fu-Quan FangHai-Ying Kong

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