• R Sanchez and E Nygård.
• Department of Cardiothoracic Anesthesia, Copenhagen Heart Center, Hellerup, Denmark.
• J. Cardiothorac. Vasc. Anesth. 1998 Apr 1;12(2):170-3.

ObjectiveTo assess the risk of hemorrhagic complications associated with epidural anesthesia in patients undergoing coronary artery bypass grafting.DesignA prospective study.SettingA cardiac surgical center associated with a university.ParticipantsFive hundred fifty-eight consecutive patients scheduled for coronary artery bypass surgery.InterventionsA Tuohy 18G epidural catheter was inserted the day before surgery in all patients.Measurements And Main ResultsPreoperative coagulation tests, such as platelet count and prothrombin time, were performed. No patient was on oral anticoagulation therapy or had coagulation disorders. Four hundred three (72%) patients were on antiplatelet therapy, which was terminated at least 1 week before surgery. The epidural catheter was left in situ for up to 5 days. All patients were observed daily for signs of spinal cord compromise, such as radicular back pain or progressive sensory or motor deficits. There were no documented spinal hematomas.ConclusionBy following certain guidelines, the risk for the development of epidural hematoma is not increased in patients undergoing epidural anesthesia during cardiac surgery.

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