RT Book, Section
A1 Benzon, Honorio T.
A2 Hadzic, Admir
SR Print(0)
ID 55901319
T1 Chapter 8. Regional Anesthesia in the Anticoagulated Patient
T2 Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-154963-9
LK accessanesthesiology.mhmedical.com/content.aspx?aid=55901319
RD 2024/04/19
AB The  incidence  of  intraspinal  hematoma  is  approximately  0.1  per  100,000  patients  per  year.1  It  is  more  likely  to  occur  in  anticoagulated  or  thrombocytopenic  patients,  patients  with  neoplastic  disease,  or  in  those  with  liver  disease  or  alcoholism.2  The  incidence  of  neurologic  dysfunction  resulting  from  hemorrhagic  complications  associated  with  neuraxial  blockade  is  estimated  to  be  <1  in  150,000  epidural  procedures  and  <1  in  220,000  with  spinal  anesthetics.  The  risk  of  formation  of  intraspinal  hematoma  after  administration  of  neuraxial  injections  is  increased  in  patients  who  received  anticoagulant  therapy  or  have  a  coagulation  disorder,  technical  difficulties  in  the  performance  of  the  neuraxial  procedures  due  to  anatomic  abnormalities  of  the  spine,  and  multiple  or  bloody  punctures.  The  American  Society  of  Regional  Anesthesia  and  Pain  Medicine  (ASRA)  issued  recommended  guidelines  for  the  safe  performance  of  neuraxial  blocks  in  patients  who  are  on  anticoagulants.3,4  The  third  edition  of  the  ASRA  guidelines  was  published  in  2010.