Journal Article10.1097/00000542-198155060-00002
Anticoagulation Following Placement of Epidural and Subarachnoid Catheters: An Evaluation of Neurologic Sequelae
T. L. K. Rao,Adel A. El-Etr +1 more
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TL;DR: This investigation shows that the occurrence of symptomatic hematomas following anticoagulation in patients with epidural or subarachnoid catheters is a very rare complication, assuming proper patient selection, an atraumatic technique, and appropriate monitoring of antICOagulant activity.
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Abstract: The incidence of neurologic complications arising from anticoagulant therapy, following epidural and subarachnoid catheterization in 3,164 and 847 patients, respectively, was determined. Twenty patients experienced minor neurologic complications or low back pain which was self-limiting and resolved with time. There was no incidence of peridural hematoma leading to spinal cord compression. This investigation shows that the occurrence of symptomatic hematomas following anticoagulation in patients with epidural or subarachnoid catheters is a very rare complication, assuming proper patient selection, an atraumatic technique, and appropriate monitoring of anticoagulant activity.
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Citations
Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition).
Terese T. Horlocker,Denise J. Wedel,John C. Rowlingson,F. Kayser Enneking,Sandra L. Kopp,Honorio T. Benzon,David L. Brown,John A. Heit,Michael F. Mulroy,Richard W. Rosenquist,Michael Tryba,Chun-Su Yuan +11 more
TL;DR: The ASRA consensus statements represent the collective experience of recognized experts in the field of neuraxial anesthesia and anticoagulation and are based on case reports, clinical series, pharmacology, hematology, and risk factors for surgical bleeding.
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TL;DR: Neuraxial anesthesia and analgesia provide several advantages over systemic opioids, including superior analgesia, reduced blood loss and need for transfusion, decreased incidence of graft occlusion, and improved joint mobility following major knee surgery.
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Spinal hematoma: a literature survey with meta-analysis of 613 patients
TL;DR: Doctors should require strict indications for the use of spinal anesthetic procedures in patients receiving anticoagulant therapy, even if the incidence of spinal hematoma following this combination is low, and close monitoring of the neurological status of the patient is warranted.
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Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcome
Michael T. Lawton,Randall W. Porter,Joseph E. Heiserman,Ronald Jacobowitz,Volker K.H. Sonntag,Curtis A. Dickman +5 more
TL;DR: This large series of SEH demonstrates that rapid diagnosis and emergency surgical treatment maximize neurological recovery, however, patients with complete neurological lesions or long-standing compression can improve substantially with surgery.
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