November 24, 2004Anesthesiology

Spinal Epidural Hematoma after Spinal Anesthesia in a Patient Treated with Clopidogrel and Enoxaparin

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Structured PICO

Population

1 81-year-old woman with ischemic heart disease (CCS grade II), atrial fibrillation, compensated renal insufficiency, hypertension, and insulin-dependent diabetes undergoing elective fasciotomy and perforator vein ligation.

Intervention

Spinal anesthesia and postoperative enoxaparin 40 mg (at 8 and 36 hours post-puncture) following a 7-day discontinuation of clopidogrel 75 mg daily.

Outcome

Development of spinal epidural hematomasafety

This case highlights the potential risk of spinal epidural hematoma after spinal anesthesia in patients recently treated with clopidogrel, even when adhering to the recommended 7-day therapy-free interval.

Discussion

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Implication

May signal inadequate 7-day clopidogrel washout for neuraxial anesthesia; hypothesis-generating and should not yet change practice.

Cite This Study

Litz et al. (2004) studied this question.

synapsesocial.com/papers/6a89243e26058a3c52131e86 https://doi.org/10.1097/00000542-200412000-00030

Topics

Dual antiplatelet therapy

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Spinal Epidural Hematoma after Spinal Anesthesia in a Patient Treated with Clopidogrel and Enoxaparin

Structured PICO

Discussion

Implication

Cite This Study

Topics

Spinal Epidural Hematoma after Spinal Anesthesia in a Patient Treated with Clopidogrel and Enoxaparin

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider