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Epidural hematoma associated with dextran infusion.

Jesse J Muir1, Eric J Church, Kent P Weinmeister

  • 1Department of Anesthesiology, Mayo Clinic, Scottsdale, AZ 85259, USA.

Southern Medical Journal
|October 1, 2003
PubMed
Summary
This summary is machine-generated.

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Dextran infusion may increase the risk of epidural hematoma in patients receiving epidural analgesia after vascular surgery. Careful consideration of anticoagulant use with epidural anesthesia is recommended.

Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Vascular Surgery

Background:

  • Epidural analgesia is frequently used for postoperative pain management in vascular surgery.
  • Dextran is an anticoagulant agent sometimes used postoperatively.

Observation:

  • A case of epidural hematoma occurred in a patient who received dextran infusion after peripheral vascular surgery with epidural analgesia.
  • The patient developed a significant neurological deficit due to the hematoma.

Findings:

  • Dextran may possess anticoagulant properties that can potentiate the risk of bleeding complications, such as epidural hematoma, when combined with epidural anesthesia.
  • The precise mechanisms of dextran's anticoagulant effect, potentially involving platelet function impairment, warrant further investigation.

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Implications:

  • This case highlights the potential risks of using dextran in patients undergoing procedures involving neuraxial techniques like epidural anesthesia.
  • Guidelines for anticoagulant therapy in patients receiving epidural anesthesia should be carefully reviewed and potentially revised to include agents like dextran.
  • Clinicians should maintain a high index of suspicion for epidural hematoma in patients with neurological symptoms who have received both dextran and epidural anesthesia.