Spinal haematoma after removal of a thoracic epidural catheter in a patient with coagulopathy resulting from unexpected vitamin K deficiency. (15th May 2013)

• Record Type: Journal Article
• Authors: Ladha, A.; Alam, A.; Idestrup, C.; Sawyer, J.; Choi, S.
• Is Part Of: Anaesthesia. Volume 68:Number 8(2013:Aug.)
• Page Start: 856
• Page End: 860
• Publication Date: 2013-05-15
• Subjects: Anesthesia -- Periodicals; 617.96
• DOI: 10.1111/anae.12285
• Languages: English
• ISSNs: 0003-2409

Abstract

Summary: Postoperative epidural analgesia is effective and widely utilised after major abdominal surgery. Spinal haematoma is a rare and devastating complication after epidural analgesia. Well‐established risk factors for the development of spinal haematoma after neuraxial procedures have been documented. We present the case of a patient with normal pre‐operative coagulation parameters who developed a spinal haematoma more than 24 h after removal of an epidural catheter; she had been without oral intake for only 4 days during which time she developed vitamin K‐deficient coagulopathy. Clinicians should consider pre‐operative screening of coagulation (International Normalised Ratio), or giving vitamin K supplementation, before performing neuraxial procedures in patients who are at risk of developing vitamin K deficiency or coagulopathy in the peri‐operative period.