Paresia prolongada poscesárea en miembro inferior: ¿anestesia en el ojo del huracán?

The case exposes a lower left limb paresis within the cesarean section postoperative time, which was performed under subarachnoidal anesthesia. The reason for the cesarean section was the breech presentation. The pregnant patient, who suffered from gestational diabetes and overweight, presented a torpid postoperative due to a motor walking/standing deficiency, accompanied by left inguinal pain without apparent etiology. An MRI was performed to prevent possible complications, which discarded an epidural hematoma as well as an anesthetic complication over the lumbar roots. It only showed a wide soft tissue edema of considerable size, which was discarded as the cause of the neuropathy by the Radiology Service. Five days after discharge a 38,5°C fever and wound suppuration were added to the already existing clinic. She was diagnosed with celulitis, which required surgical drainage of the abscess. The intervetion provided pain relieved aluthough 3 weeks after she still presented a certain degree of difficulty when walking. Given the location of the femoral nerve near the cesarean incision zone (lower transversal abdominal section), it can be affected by surgical instruments and further complications (hematomas, abcesses). After the celulitis diagnose it was hypothesized that the femoral neuropathy had been an nervous irritation at the infrainguinal level. Other etiologies for an unilateral paresis in a puerpera could be: the pregnancy itself, the lithotomy position, the vasa nervorum ischemia or the retroperitoneal hematoma. (DOLOR. 2019;34:123-6) [ABSTRACT FROM AUTHOR]