Two cases of epidural anesthesia-associated postoperative decubitus

Authors: Takahashi, Eri; Isonishi, Seiji¹; Suzuki, Michiko¹; Ogura, Asako¹; Kunito, Shiro¹; Hirama, Masanori¹; Shoji, Hirokazu²; Ochiai, Kazuhiko¹; Tanaka, Tadao³

Source: The Journal of Obstetrics and Gynaecology Research, Volume 34, Supplement 1, August 2008 , pp. 763-766(4)

Publisher: Wiley-Blackwell

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Abstract:

Very few cases of postoperative decubitus have been reported. We report two cases of hip decubitus after myomectomy. Case 1 is a 32-year-old Japanese woman who underwent an uncomplicated myomectomy under the combination of general and epidural anesthesia. Twelve hours after surgery, a palpable soft tissue mass developed in the sacral region. On day 3, the soft tissue mass had disappeared and the patient was discharged on day 8. Case 2 is a 33-year-old woman. Under a combination of spinal and epidural anesthesia, a myomectomy was carried out. On day 1 after surgery, a hard mass with redness was detected. On day 8, decubitus improved and she was discharged. We evaluated the temporal changes in anesthetic level in four independent cases. Eighteen hours after surgery, the anesthetic effect still continued below the L2 level. We conclude that the extended effect of epidural anesthesia might be one of the mechanisms causing postoperative decubitus.

Keywords: decubitus; epidural anesthesia; gynecological surgery; myomectomy; uterine leiomyoma

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1447-0756.2008.00922.x

Affiliations: 1: Departments of Obstetrics and Gynecology and 2: Anesthesiology, Jikei University Aoto Hospital, and 3: Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan

Publication date: 2008-08-01