Document Detail

Epidural anaesthesia and spinal haematoma.
MedLine Citation:
PMID:  8955979     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Haematoma formation in the spinal canal due to epidural anaesthesia is a very rare but serious complication. This paper presents a comprehensive review of case reports. SOURCE: Sampling of case reports over a 10 yr period, medline-research (1966-1995) and cross-check with former reviews. FINDINGS: Fifty-one confirmed spinal haematomas associated with epidural anaesthesia were found. Most were related to the insertion of a catheter, a procedure that was graded as difficult or traumatic in 21 patients. Other risk factors were: fibrinolytic therapy (n = 2), previously unknown spinal pathology (n = 2), low molecular weight heparin (n = 2), aspirin or other NSAID (n = 3), epidural catheter inserted during general anaesthesia (n = 3), thrombocytopenia (n = 5), ankylosing spondylitis (n = 5), preexisting coagulopathy (n = 14), and intravenous heparin therapy (n = 18). CONCLUSION: Coagulopathies or anticoagulant therapy (e.g., full heparinization) were the predominant risk factors, where-as low-dose heparin thromboprophylaxis or NSAID treatment was rarely associated with spinal bleeding complications. Ankylosing spondylitis was identified as a new, previously unreported risk factor. Analysis of reported clinical practice suggests an incidence of haematoma of 1:190,000 epidurals.
H Wulf
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  43     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-03-07     Completed Date:  1997-03-07     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  1260-71     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the Christian-Albrechts-University of Kiel, Germany. H.WULF@ANAESTHESIE.UNI-KIEL.DE
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MeSH Terms
Anesthesia, Epidural / adverse effects*
Hematoma / etiology*
Risk Factors
Spinal Canal*
Spondylitis, Ankylosing / complications
Comment In:
Can J Anaesth. 1997 Dec;44(12):1319   [PMID:  9429054 ]

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