Neuraxial Hematoma and Paralysis After Enoxaparin Administration 3 Days After Attempted Spinal Anesthesia for Total Knee Arthroplasty

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• 作者：David F. Bindelglass ; David S. Rosenblum
• 关键词：total knee arthroplasty ; VTE ; anticoagulation ; complications
• 刊名：The Journal of Arthroplasty
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：25
• 期：7
• 页码：1169.e9-1169.e11
• 全文大小：70 K

文摘

A 69-year-old man underwent a total knee arthroplasty. Spinal anesthesia was attempted, but when unsuccessful, a general anesthesia was given. The surgery and rehabilitation were uneventful until postoperative day 3 when a pulmonary embolism was diagnosed. He was placed on enoxaparin at a therapeutic dose that begun more than 72 hours after his attempted spinal. He developed a spinal hematoma and was paralyzed. The literature has no recommendations for using enoxaparin at therapeutic doses after regional anesthesia. There is no previous report to suggest that a patient 72 hours after surgery is still at risk from a neuraxial hematoma.