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About the author DB. Epidural anesthesia later; attempts at resuscitation were unsuccessful. Their role in postoperative outcome. Autopsy revealed a 2 to 3 L hematoma in the psoas Anesthesiology ; Effects of epidural anes- rather than neural deficits, may be the most serious thesia and analgesia on coagulation and outcome complication of non-neuraxial regional techniques after major vascular surgery. Anesth Analg ; in the anticoagulated patient.
Additional informa- Modig J. The role of lumbar epidural anaesthesia as antithrombotic prophylaxis in total hip replace- Conservatively, the Consensus Statements on ment. Acta Chirurgica Scand ; Neuraxial Anesthesia and Anticoagulation may be 4. Effects of perioperative However, this may be more restrictive than neces- analgesic technique on the surgical outcome and sary. Practice guidelines or recommendations summa- Anesthesiology ; However, the rarity of 5. American College of Chest Physicians and the Na- spinal hematoma defies a prospective-randomized tional Heart, Lung and Blood Institute National study, and there is no current laboratory model.
As Conference on Antithrombotic Therapy. Chest ; SS. Prevention of ve- field of neuraxial anesthesia and anticoagulation. Anticoagulation and bleeding. An understanding of the complexity of neuraxial block: Historical perspective, anesthetic this issue is essential to patient management; a implications, and risk management. Rather, Med ; Cathet Cardiovasc Intervent ; Bleeding though definite risk of spinal hematoma with the complications with enoxaparin for deep venous benefits of regional anesthesia for a specific patient.
J Arthroplasty ; Alternative anesthetic and analgesic techniques ex- The Do antiplatelet agents ment, and the level of anticoagulation must be contribute to the development of perioperative spi- carefully monitored during the period of epidural nal hematoma? Reg Anesth Pain Med ; catheterization.
Indwelling catheters should not be Reg Anesth Pain Med ; risk of spinal hematoma. It must also be remem- Neuraxial anesthesia and anal- lishment of guidelines will not completely eliminate gesia in the presence of standard heparin. Reg Anesth the complication of spinal hematoma. In Vander- Pain Med ; Vigilance in monitoring is critical to allow early Ex- evaluation of neurologic dysfunction and prompt tensive retroperitoneal hematoma without neuro- intervention.
Anesthe- dial infarction—A case report. J Spinal Cord Med siology ; Spi- Zenz M. Severe bleeding following lumbar sympa- nal epidural hematoma following thrombolytic thetic blockade in two patients under medication therapy for acute myocardial infarction.
Orthopedics with irreversible platelet aggregation inhibitors. An- ; Spinal epidural sensus Conference on Antithrombotic Therapy. Thrombo- Jpn Heart J ; Brown DL.
Frequency of myocardial infarction, pul- Neurosurgery ; Man- death following primary hip or knee arthroplasty. Spine ; Wulf H. Epidural anaesthesia and spinal haema- acute myocardial infarction. A report of the Amer- toma. Can J Anaesth ; Spinal epidural hematoma associated on Management of Acute Myocardial Infarction.
Hem- cular thrombolytic therapy. Anesthesiology ; orrhagic complications of anticoagulant treatment. Onishchuk JL, Carlsson C. Epidural hematoma as- Hemorrhagic complications of thrombolytic anticoagulant therapy. Anesthesiology ; therapy in the treatment of myocardial infarction Intra- ;SS.
Tryba M. Anesth Analg ; Preoperative D, Poller L. Heparin: Mechanism of action, pharma- antiplatelet therapy does not increase the risk of cokinetics, dosing considerations, monitoring, effi- spinal hematoma with regional anesthesia.
Anesth cacy, and safety. Chest ;SS. Analg ; Stafford-Smith M. Heparin detection by the gional anaesthesia. Can J Anaesth R activated coagulation time: A comparison of the Anti- J Cardiothorac Vasc Anesth ; Anesth Small sub- N Engl J Med ; Anesthesiology ; Complications of anticoag- Therapeutics, ed 8.
Anticoagulation following place- Paraplegia sub- evaluation of neurologic sequelae. Anesthesiology sequent to administration of tissue plasminogen ac- ; Anaesthesia coagulant therapy.
Is the combination safe? Anaes- ; Epidural anaesthesia and spinal haema- Hemostasis-altering drugs and central neural Chaney MA. Intrathecal and epidural anesthesia block—A survey of anesthetic practice in Scotland and analgesia for cardiac surgery.
Anesth Analg and the United Kingdom. Reg Anesth Pain Med ; ; A survey of spinal and epidural tudes and practices of New Zealand anaesthetists techniques in adult cardiac surgery.
J Cardiothorac with regard to epidural and subarachnoid anaesthe- Vasc Anesth ; Anaesth Intensive Care ; A retrospective Greaves JD. Serious spinal cord injury due to examination of regional plus general anesthesia in haematomyelia caused by spinal anaesthesia in a children undergoing open heart surgery.
Anesth patient treated with low-dose heparin. Anaesthesia Analg ; Epi- Reitz BA. A report of two hundred twenty cases of dural hematoma following epidural analgesia in a regional anesthesia in pediatric cardiac surgery.
Reg Anesth Pain Med ; Sanchez, R, Nygard, E. Epidural anesthesia in car- Cosmi B, Hirsh J. Low molecular weight heparins.
J Cardiotho- Curr Opin Cardiol ; The relationship be- Ralley FE. Neuraxial anesthesia is contraindicated in tween anti-factor Xa level and clinical outcome in patients undergoing heparinization for surgery. Pro: patients receiving enoxaparin low molecular weight neuraxial anesthesia should not be used in patients heparin to prevent deep vein thrombosis after hip replacement.
Thromb Haemost ; J Cardiotho- Turnbull KW. Neuraxial anesthesia is contraindi- BL. Monitoring the anticoagulant effects of a low cated in patients undergoing heparinization for sur- molecular weight heparin preparation. Correlation gery. Con: neuraxial block is useful in patients un- of assays in orthopedic surgery patients receiving dergoing heparinization for surgery. J Cardiothorac ardeparin sodium for prophylaxis of deep venous Vasc Anesth ; Am J Clin Pathol ; Protamine neutralization left anterior thoracotomy in the conscious patient.
An exper- Thoracic imental investigation in healthy volunteers. Blood epidural anesthesia for off-pump coronary artery Coagul Fibrinolysis ; Eur J Cardiothorac Surg Evaluation of hemo-
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