Neuraxial hematoma and paralysis after enoxaparin administration 3 days after attempted spinal anesthesia for total knee arthroplasty.

Bindelglass, David F; Rosenblum, David S · J Arthroplasty · 2010

case_report · Level V

Where this comes from

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

Anatomy