TMSS Medical College Journal

A 90 years old woman presented with large haematoma, hypertension with bronchial asthma. After doing all physical examinations, relevant investigations and managing the associated diseases, the haematoma was removed under epidural anaesthesia. Postoperative pain control was done with epidural lignocaine. Over all our come was good.

Coronary angiogram is the gold standard in evaluating coronary arterial disease & is associated with an acceptively low complication rate(<1%). Haematoma formation in a puncture site is a rare complication because puncture site is managed addecuately though there have a chance. Small haematoma need not surgical intervention but large haematoma requires surgical intervention. Cosidering patient codition, Epidural anaesthesia was selected for surgical procedure because epidural technique have prove to be extremly safe when managed well?. Epidural block may be performed at any level of the vertebral column to provide segmental analgesia over an area that can be predetermined with reasonable success. Epidural or spinal opioids which may cause delayed respiratory depression and therefore their use is dependent on the availability of appropriate post operative care?. Anaesthesia is provided by the effect of the local anaesthetic drugs (e.g. 0.5% bupivacaine, 2% lidocaine) on the spinal nerve root as they pass from the spinal cord to the periphery through the epidural space. Analgesia can provided by the same mechanism, with the addition of opioidst.Epidural analgesia is the most effective method for the management of significant acute pain. Epidural analgesia provided by local anaesthetics (with or without an addition of an opiod) may lead to a reduction in postoperative complications and improve patient outcome, especially in high risk patients.