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Case report: pneumocephalia after epidural anesthesia for hip replacement surgery


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Abstract

Lumbar epidural anesthesia is a commonly used anaesthetic technique for trauma and orthopedic surgery of the lower extremities. One of the rare complications of epidural anesthesia is pneumocephalia. The article describes a case of pneumocephalia after epidural anesthesia performed for anesthetic management of the hip replacement surgery. Eight hours after the epidural anesthesia the patient had depression of consciousness progressing to coma. Computed tomography of the brain detected pneumocephalia. Symptomatic treatment provided a regression of neurological deficit. CT scanning of the brain on the 8th postoperative day showed resolution of pneumocephalia. The patient was discharged from the hospital on the 15th day after surgery. The most probable mechanism explaining this case of pneumocephalia development is the theory of «the inverted bottle».


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