1. Spinal haematoma after removal of a thoracic epidural catheter in a patient with coagulopathy resulting from unexpected vitamin K deficiency.
- Author
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Ladha A, Alam A, Idestrup C, Sawyer J, and Choi S
- Subjects
- Aged, Anesthesia, General, Anticoagulants therapeutic use, Blood Coagulation Disorders prevention & control, Blood Coagulation Factors analysis, Enoxaparin therapeutic use, Gastrointestinal Neoplasms surgery, Gastrointestinal Stromal Tumors surgery, Humans, International Normalized Ratio, Male, Thrombosis prevention & control, Analgesia, Epidural adverse effects, Blood Coagulation Disorders complications, Catheterization adverse effects, Hematoma, Subdural, Spinal etiology, Vitamin K Deficiency complications, Vitamin K Deficiency Bleeding complications
- Abstract
Postoperative epidural analgesia is effective and widely utilised after major abdominal surgery. Spinal haematoma is a rare and devastating complication after epidural analgesia. Well-established risk factors for the development of spinal haematoma after neuraxial procedures have been documented. We present the case of a patient with normal pre-operative coagulation parameters who developed a spinal haematoma more than 24 h after removal of an epidural catheter; she had been without oral intake for only 4 days during which time she developed vitamin K-deficient coagulopathy. Clinicians should consider pre-operative screening of coagulation (International Normalised Ratio), or giving vitamin K supplementation, before performing neuraxial procedures in patients who are at risk of developing vitamin K deficiency or coagulopathy in the peri-operative period., (Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.)
- Published
- 2013
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