The Journal of Arthroplasty
Volume 25, Issue 7 , Pages 1169.e9-1169.e11, October 2010

Neuraxial Hematoma and Paralysis After Enoxaparin Administration 3 Days After Attempted Spinal Anesthesia for Total Knee Arthroplasty

  • David F. Bindelglass, MD

      Affiliations

    • The Joint Reconstruction Center at Bridgeport Hospital, Bridgeport, Connecticut
    • Corresponding Author InformationReprint requests: David F. Bindelglass, MD, Orthopaedic Specialty Group, 75 King's Highway Cut-off, Fairfield, CT 06824.
    • ,
  • David S. Rosenblum, MD

      Affiliations

    • Gaylord Hospital, Wallingford, Connecticut

Received 28 January 2009; accepted 25 July 2009. published online 19 October 2009.

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.

Keywords: total knee arthroplasty, VTE, anticoagulation, complications

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 No benefits or funds were received in support of this study.

PII: S0883-5403(09)00357-X

doi:10.1016/j.arth.2009.07.022

The Journal of Arthroplasty
Volume 25, Issue 7 , Pages 1169.e9-1169.e11, October 2010

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