Why the study?
Does epidural analgesia cause neurologic complications in parturients with platelet counts between 69,000 and 98,000 mm-3?
Does epidural analgesia cause neurologic complications in parturients with platelet counts between 69,000 and 98,000 mm-3?
Epidural analgesia may be safe in parturients with platelet counts between 69,000 and 98,000 mm-3, challenging the recommendation to withhold it below 100,000 mm-3.
No complications documented in this cohort; leaves open epidural safety in moderate thrombocytopenia pending prospective data.
Regional anesthesia is a popular form of pain relief for the management of labor and delivery.Thrombocytopenia is considered a relative contraindication to the administration of regional anesthesia. Some authorities have recommended that an epidural anesthetic be withheld if the platelet count is <100,000 mm-3. For the period of March 1993 through February 1996, we reviewed the charts of all parturients who had a platelet count <100,000 mm-3 during the peripartum period. Eighty women met this criterion. Of these 80,30 had an epidural anesthetic placed when the platelet count was <100,000 mm-3 (range 69,000-98,000 mm-3), 22 had an epidural anesthetic placed with a platelet count >100,000 mm-3 that subsequently decreased below 100,000 mm-3, and 28 did not receive a regional anesthetic. We found no documentation of any neurologic complications in the medical records. We conclude that regional anesthesia should not necessarily be withheld when the platelet count is <100,000 mm-3. (Anesth Analg 1997;85:385-8)
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Beilin et al. (1997) studied this question.
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