• J Arthroplasty · Oct 2010

    Case Reports

    Neuraxial hematoma and paralysis after enoxaparin administration 3 days after attempted spinal anesthesia for total knee arthroplasty.

    • David F Bindelglass and David S Rosenblum.
    • The Joint Reconstruction Center at Bridgeport Hospital, Bridgeport, Connecticut, USA.
    • J Arthroplasty. 2010 Oct 1; 25 (7): 1169.e9-11.

    AbstractA 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.Copyright © 2010 Elsevier Inc. All rights reserved.

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