Estimating the incidence of dpinal epidural hematoma after central neuroaxial blockades: a retrospective review of 38,168 cases in cancer clinic

Roman V. Garjaev , E. S Gorobets , P. I Feoktistov , I. E Karmanov

Regional Anesthesia and Acute Pain Management ›› 2016, Vol. 10 ›› Issue (1) : 30 -39.

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Regional Anesthesia and Acute Pain Management ›› 2016, Vol. 10 ›› Issue (1) : 30 -39. DOI: 10.17816/RA42802
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Estimating the incidence of dpinal epidural hematoma after central neuroaxial blockades: a retrospective review of 38,168 cases in cancer clinic

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Abstract

Neuraxial blockades provide effective pain relief. There are some benefits of prolonged epidural analgesia versus systemic opioids via PCA. Unfortunately, severe hemorrhagic complications can occur after application of these blockades. Methods: poll of all anesthesiologists working in cancer clinic during 2001-2015, search of data in medical archive. Results: it was revealed 2 cases of spinal hematoma following 30,042 epidural anesthetics and 0 cases among 8,126 spinal techniques. Both of complications were associated with evidence of hemostatic abnormality, there were no neurologic symptoms; patients had a conservative treatment and good outcomes. Conclusions: the incidence of spinal epidural hematoma after prolonged epidural analgesia was 0.67 per 10,000 (95% CI 0.57-0.76per 10,000), after spinal anesthesia - 0 per 8,126.

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spinal epidural hematoma / neuraxial blockades

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Roman V. Garjaev, E. S Gorobets, P. I Feoktistov, I. E Karmanov. Estimating the incidence of dpinal epidural hematoma after central neuroaxial blockades: a retrospective review of 38,168 cases in cancer clinic. Regional Anesthesia and Acute Pain Management, 2016, 10(1): 30-39 DOI:10.17816/RA42802

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References

[1]

Beattie W.S., Badner N.H., Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth. Analg. 2001; 93: 853-858.

[2]

Ballantyne J.C., Carr D.B., de Ferranti S. et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome:cumulative meta-analyses of randomized, controlled trials. Analg. Anesth.1998; 86: 598-612.

[3]

Jorgensen H., Wetterslev J., Moiniche S. et al. Epidural local anesthetics versus opioid-based analgesic regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery. Cochrane database Syst. Rev. 2000:CD001893.

[4]

Rodgers A., Walker N., Schug S. et al. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia: results from overview of randomized trials. BMJ. 2000; 321: 1493.

[5]

Horlocker T.T., Wedel D.J., Schroeder D.R. et al. Preoperative antiplatelet therapy does not increase the risk of spinal hematoma associated with regional anesthesia. Anesth. Analg. 1995; 80(2): 303-309.

[6]

Vandermeulen E.P., Van Aken H., Vermylen J. Anticoagulants and spinal-epidural anesthesia. Anesth Analg. 1994; 79: 1165-1177.

[7]

Lim Y.J., Bahk J.H., Ahn W.S., Lee S.C. Coiling of lumbar epidural catheters. Acta Anaesthesiol. Scand. 2002; 46: 603-606.

[8]

Choi D.H., Lee S.M, Cho H.S., Ahn H.J. Relationship between the bevel of the Tuohy needle and catheter direction in thoracicepidural anesthesia. Reg. Anesth. Pain Med. 2006; 31: 105-112.

[9]

Asato F., Goto F.Radiographic findings of unilateral epidural block. Anesth. Analg. 1996; 83(3): 519-522.

[10]

Brookman J.C., Sair H.I., Benkwitz C., Gulur P.Wandering epidural catheter. Anesthesiology. 2010; 113 (5): 1198.

[11]

Stafford-Smith M. Impaired haemostasis and regional anaesthesia. Can. J. Anaesth. 1996; 43(5 Pt 2): 129-141.

[12]

Gogarten W., Vandermeulen E., Van Aken H., Kozek S., Llau J.V., Samama C.M. Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur. J. Anaesthesiol. 2010; 27 (12): 999-1015.

[13]

Anticoagulation guidelines for neuroaxial or peripheral nerve procedures. University of Washington Medical Center, March 19, (2012). Available at: https://depts.washington.edu/anticoag/home/content/neuraxial-guidelines (accessed 22 December 2015).

[14]

Horlocker T.T., Wedel D.J., Rowlingson J.C. et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg. Anesth. Pain Med. 2010; 35 (1): 64-101.

[15]

Lee L.A., Posner K.L., Domino K.B., Caplan R.A., Cheney F.W. Injuries associated with regional anesthesia in the 1980s and 1990s: a closed claims analysis. Anesthesiology. 2004; 101: 143-152.

[16]

Moen V., Dahlgren N., Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology. 2004; 101: 950-959.

[17]

Horlocker T.T., Wedel D.J. Neuraxial block and low-molecularweight heparin: balancing perioperative analgesia and thromboprophylaxis. Reg. Anest. Pain Med. 1998; 23: 164-177.

[18]

Neal J., Rathmell J.P., eds. Complications in Regional Anesthesia and Pain Medicine. 2nd ed. Lippincott Williams & Wilkins; 2012. 495 p.

[19]

Ehrenfeld J.M., Agarwal A.K., Henneman J.P., Sandberg W.S. Estimating the incidence of suspected epidural hematoma and the hidden imaging cost of epidural catheterization: a retrospective review of 43,200 cases. Reg. Anest. Pain Med. 2013; 38 (5): 409-414.

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