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Spinal haematoma after removal of a thoracic epidural catheter in a patient with coagulopathy resulting from unexpected vitamin K deficiency
Author(s) -
Ladha A.,
Alam A.,
Idestrup C.,
Sawyer J.,
Choi S.
Publication year - 2013
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12285
Subject(s) - medicine , coagulopathy , surgery , complication , anesthesia
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.