Epidural Hematoma and Abscess Related to Thoracic Epidural Analgesia: A Single-Center Study of 2,907 Patients Who Underwent Lung Surgery

J Cardiothorac Vasc Anesth. 2017 Apr;31(2):446-452. doi: 10.1053/j.jvca.2016.07.022. Epub 2016 Jul 18.

Abstract

Objective: To report the major complications (epidural hematoma and abscess) of postoperative thoracic epidural analgesia in patients who underwent lung surgery.

Design: Prospective, monocentric study.

Setting: A university hospital.

Participants: All lung surgical patients who received postoperative thoracic epidural analgesia between November 2007 and November 2015.

Interventions: Thoracic epidural analgesia for patients who underwent lung surgery.

Measurements and main results: During the study period, data for 2,907 patients were recorded. The following 3 major complications were encountered: 1 case of epidural hematoma (0.34 case/1,000; 95% confidence interval 0.061-1.946), for which surgery was performed, and 2 cases of epidural abscesses (0.68 case/1,000; 95% confidence interval 0.189-2.505), which were treated medically.

Conclusions: The risk range of serious complications was moderate; only the patient who experienced an epidural hematoma also experienced permanent sequelae.

Keywords: epidural abscess; epidural hematoma; lung surgery; postoperative analgesia; thoracic epidural analgesia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesia, Epidural / adverse effects*
  • Analgesia, Epidural / trends
  • Female
  • Hematoma, Epidural, Spinal / diagnostic imaging*
  • Hematoma, Epidural, Spinal / epidemiology
  • Humans
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / surgery*
  • Male
  • Middle Aged
  • Pain Management / methods
  • Prospective Studies
  • Retrospective Studies
  • Thoracic Vertebrae / diagnostic imaging*
  • Young Adult