RT Book, Section
A1 Benzon, Honorio T.
A1 Jabri, Rasha S.
A1 Zundert, Tom C. Van
A2 Hadzic, Admir
SR Print(0)
ID 1141736664
T1 Neuraxial Anesthesia & Peripheral Nerve Blocks in Patients on Anticoagulants
T2 Hadzic's Textbook of Regional Anesthesia and Acute Pain Management, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071717595
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1141736664
RD 2024/04/24
AB Intraspinal  hematoma  is  a  relatively  rare  condition  resulting  from  a  variety  of  causes.  Traumatic  causes  include  lumbar  puncture  and  neuraxial  anesthesia.  It  is  more  likely  to  occur  in  anticoagulated  or  thrombocytopenic  patients,  patients  with  neoplastic  disease,  or  in  those  with  liver  disease  or  alcoholism.  Approximately  one-quarter  to  one-third  of  all  cases  are  associated  with  anticoagulation  therapy.  The  risk  of  intraspinal  hematoma  formation  after  administration  of  neuraxial  anesthesia  and  analgesia  is  increased  in  patients  who  have  received  anticoagulant  therapy  or  have  a  coagulation  disorder.1  For  this  reason,  neuraxial  anesthesia  is  often  contraindicated  in  the  presence  of  a  coagulopathy.  Other  risk  factors  for  the  development  of  epidural  or  spinal  hematoma  include  technical  difficulty  (multiple  attempts)  in  the  performance  of  the  neuraxial  procedures  due  to  anatomic  abnormalities  of  the  spine  and  multiple  or  bloody  punctures.