Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T15:08:24.389Z Has data issue: false hasContentIssue false
  • English
  • Français

Thoracotomy Paraplegia: A Case Report from the PACU

Published online by Cambridge University Press:  01 May 2011

Tzu H. Huang
Tzu H. Huang*
Affiliation:
Advanced Practitioner, Perioperative Service, Post Anaesthesia Care Unit, The Canberra Hospital, ACT, Australia
*
Correspondence to: T. H. Huang, Post-anaesthesia Care Unit, The Canberra Hospital, Yamba Drive, Garran ACT 2605, Australia. Tel: 0433 645 384; Fax: 02-6282 6984; E-mail: [email protected]
Get access

Abstract

The aim of this case report is to present the rare yet devastating complication of post-thoracotomy paraplegia and to raise awareness of the causative factors, as well as to discuss the nursing observation for prompt and effective clinical management in order to achieve successful healthcare outcomes. This case was secondary to the use of haemostatic agents during thoracotomy, and delayed post-operative identification of complication and management leading to long-term spinal cord impairment. Routine neurologic assessment focusing on movement and sensation of the extremities is recommended post-operatively to detect the potential complications as early as possible.

Keywords

neurologic deficitsparaplegiapost-thoracotomy complication
Type
Original Article
Information
British Journal of Anaesthetic & Recovery Nursing , Volume 12 , Issue 1-2 , May 2011 , pp. 14 - 17
Copyright
Copyright © British Association of Anaesthetic and Recovery Nursing 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achneck, HE, Sileshi, B, Jamiolkowski, RM, Albala, DM, Shapiro, ML, Lawson, JH. A comprehensive review of topical hemostatic agents: efficacy and recommendations for use. Annals of Surgery 2010; 251: 217–228.CrossRefGoogle ScholarPubMed
Attar, S, Hankins, JR, Turney, SZ, Krasna, MJ, McLaughlin, JS. Paraplegia after thoracotomy: report of five cases and review of the literature. The Annals of Thoracic Surgery 1995; 59: 1410–1416.CrossRefGoogle ScholarPubMed
Brodbelt, AR, Miles, JB, Foy, PM, Broome, JC. Intraspinal oxidised cellulose (Surgical) causing delayed paraplegia after thoracotomy – a report of these causes. Annals of the Royal College of Surgeons of England 2002; 84: 97–99.Google Scholar
Crawford, ES, Crawford, JL, Safi, HJ et al. Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. Journal of Vascular Surgery 1986; 3: 389–404.CrossRefGoogle ScholarPubMed
Dogan, S, Kocaeli, H, Doygun, M. Oxidised regenerated cellulose as a cause of paraplegia after thoracotomy: case report and review of the literature. Spinal Cord 2005; 43: 445–447.CrossRefGoogle ScholarPubMed
Henry, MC, Tashjian, DB, Kasowski, H, Duncan, C, Moss, RL. Postoperative paraplegia secondary to the use of oxidized cellulose (Surgicel). Journal of Pediatric Surgery 2005; 40: E9–E11.CrossRefGoogle Scholar
John, J, Manoj, P, Nair, SG, Chandrasekharan, AP, Satyaprasad, V. Paraplegia after thoracotomy: an unusual cause. Journal of Cardiothoracic and Vascular Anesthesia 2006; 20: 696–699.CrossRefGoogle ScholarPubMed
Kaplan, M. Back pain: is it spinal cord compression. Clinical Journal of Oncology Nursing 2009; 13: 592–595.CrossRefGoogle ScholarPubMed
Kocogullari, CU, Becit, N, Erkut, B et al. Prevention of reperfusion injury of the spinal cord in aortic surgery: an experimental study. Surgery Today 2008; 38: 237–244.CrossRefGoogle ScholarPubMed
Kumar, A, Kale, SS, Dutta, R, Kumar, A. Post-thoracotomy paraplegia due to epidural migration of bone wax. European Journal of Cardio-Thoracic Surgery 2009; 35: 734–736.CrossRefGoogle ScholarPubMed
Livesay, JJ, Cooley, DA, Ventemiglia, RA et al. Surgical experience in decending thoracic aneurysmectomy with and without adjuncts to avoid ischemia. The Annals of Thoracic Surgery 1985; 39: 37–46.CrossRefGoogle Scholar
Marrs, JA. Nurse, my back hurts: understanding malignant spinal cord compression. Clinical Journal of Oncology Nursing 2006; 10: 114–116.CrossRefGoogle ScholarPubMed
Mavrogenis, AF, Pneumaticos, S, Sapkas, GS, Papagelopoulos, PJ. Metastatic epidural spinal cord compression. Orthopedics 2009; 32: 431–439.Google ScholarPubMed
McDonald, JW, Sadowsky, C. Spinal cord injury. Lancet 2002; 359: 417–425.CrossRefGoogle ScholarPubMed
Pellatt, GC. Nontraumatic spinal cord injury, part 3: care for spinal cord compression. British Journal of Neuroscience Nursing 2008; 4: 549–553.CrossRefGoogle Scholar