Atypical presentation of an epidural hematoma in a patient receiving aspirin and low molecular weight heparin. Was epidural analgesia the right choice?

Shilpa V Kasodekar; Eric Goldszmidt; Sharon R Davies

doi:10.1016/j.jclinane.2008.12.022

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Atypical presentation of an epidural hematoma in a patient receiving aspirin and low molecular weight heparin. Was epidural analgesia the right choice?

Journal article

Peer reviewed

Atypical presentation of an epidural hematoma in a patient receiving aspirin and low molecular weight heparin. Was epidural analgesia the right choice?

Shilpa V Kasodekar, Eric Goldszmidt and Sharon R Davies

Journal of clinical anesthesia, Vol.21(8), pp.595-598

12/01/2009

DOI: 10.1016/j.jclinane.2008.12.022

PMID: 20122592

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Abstract

A case of postoperative epidural hematoma with an atypical presentation and an excellent outcome in an 80 year-old woman who received both prophylactic aspirin and enoxaparin following a primary total knee arthroplasty, is presented. She developed lower limb neurological symptoms, fully recovered, and then deteriorated again. The hematoma was surgically evacuated, resulting in full neurological recovery. Epidural analgesia may not be the best choice for pain management in patients who require the combined use of aspirin and low-molecular weight heparin postoperatively.

Aged, 80 and over

Analgesia, Patient-Controlled - adverse effects

Aspirin - administration & dosage

Aspirin - adverse effects

Enoxaparin - administration & dosage

Enoxaparin - adverse effects

Female

Hematoma, Epidural, Spinal - chemically induced

Heparin, Low-Molecular-Weight - administration & dosage

Heparin, Low-Molecular-Weight - adverse effects

Humans

Platelet Aggregation Inhibitors - administration & dosage

Platelet Aggregation Inhibitors - adverse effects

Postoperative Care

Treatment Outcome

Details

Title: Subtitle: Atypical presentation of an epidural hematoma in a patient receiving aspirin and low molecular weight heparin. Was epidural analgesia the right choice?
Creators: Shilpa V Kasodekar - Mount Sinai Hospital
Eric Goldszmidt - Mount Sinai Hospital
Sharon R Davies - Mount Sinai Hospital
Resource Type: Journal article
Publication Details: Journal of clinical anesthesia, Vol.21(8), pp.595-598
DOI: 10.1016/j.jclinane.2008.12.022
PMID: 20122592
NLM abbreviation: J Clin Anesth
ISSN: 0952-8180
eISSN: 1873-4529
Language: English
Date published: 12/01/2009
Academic Unit: Anesthesia
Record Identifier: 9984948043602771

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