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- Harshal D Wagh, Prashant K Nair, and Deepak B Bhushan.
- From the Department of Anesthesiology, Kokilaben Ambani Hospital, Mumbai, India.
- A A Pract. 2023 Jun 1; 17 (6): e01693e01693.
AbstractWe report a case of a patient who had a coronary angioplasty and received heparin, clopidogrel, and ticagrelor on the evening of bilateral total knee arthroplasties performed under combined spinal epidural anesthesia. After a multidisciplinary meeting, the epidural catheter was removed 5 days after the dose of clopidogrel. With the catheter still in place, ticagrelor was continued to prevent stent thrombosis. Removing an epidural catheter in a patient on antiplatelet therapy must be done after a risk-benefit assessment, multidisciplinary collaboration, and stringent neurologic monitoring. The focus should be on prevention of a spinal hematoma, and rapid diagnosis and treatment to optimize the neurologic outcome.Copyright © 2023 International Anesthesia Research Society.
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