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

Document Type

Article

Publication Title

The Journal of arthroplasty

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.

First Page

1169.e9

Last Page

11

DOI

10.1016/j.arth.2009.07.022

Publication Date

10-1-2010

Identifier

19837550 (pubmed); 10.1016/j.arth.2009.07.022 (doi); S0883-5403(09)00357-X (pii)

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