Neuraxial Hematoma and Paralysis After Enoxaparin Administration 3 Days After Attempted Spinal Anesthesia for Total Knee Arthroplasty |
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Authors: | David F. Bindelglass David S. Rosenblum |
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Affiliation: | ? The Joint Reconstruction Center at Bridgeport Hospital, Bridgeport, Connecticut;† Gaylord Hospital, Wallingford, Connecticut |
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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. |
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Keywords: | total knee arthroplasty VTE anticoagulation complications |
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