| Epidural anaesthesia and spinal haematoma. | |
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MedLine Citation:
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PMID: 8955979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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H Wulf |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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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:
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Created Date: 1997-03-07 Completed Date: 1997-03-07 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: CANADA |
Other Details:
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Languages: eng Pagination: 1260-71 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Intensive Care Medicine, Hospital of the Christian-Albrechts-University of Kiel, Germany. H.WULF@ANAESTHESIE.UNI-KIEL.DE |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, Epidural
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adverse effects* Hematoma / etiology* Humans Risk Factors Spinal Canal* Spondylitis, Ankylosing / complications |
| Comments/Corrections | |
Comment In:
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Can J Anaesth. 1997 Dec;44(12):1319
[PMID:
9429054
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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