Neuraxial hematoma and paralysis after enoxaparin administration 3 days after attempted spinal anesthesia for total knee arthroplasty.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 19837550.
- Also identified by DOI 10.1016/j.arth.2009.07.022.
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Abstract
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.
Medical subject headings
- Anesthesia, Spinal
- Anticoagulants
- Arthroplasty, Replacement, Knee
- Enoxaparin
- Hematoma, Epidural, Spinal
- Paralysis
Anatomy
- knee