Epidural Blood Patch in a Patient Taking Enoxaparin, Following Acoustic Neuroma Resection

Scott, E. W.; Sueltenfuss, Mary S

doi:10.4172/2155-9864.1000109

Cited by 1 publication

(1 citation statement)

References 7 publications

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“…Two case reports documented successful EBPs in parturients on anticoagulation therapy when EBP was indicated. LMWH was held for 12 hours prior in one case (8) and for 24 hours in the other for prophylactic LMWH dosing (9). In both cases, LMWH was resumed 12 hours postprocedure per ASRA guidelines.…”

Section: Discussionmentioning

confidence: 99%

Considerations When Performing an Epidural Blood Patch on a Patient Anticoagulated with Low Molecular Weight Heparin: A Case Report

Sheeran¹,

MacCormick²,

Kohan³

2021

PMCR

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BACKGROUND: Epidural blood patch (EBP) procedure timing can be difficult in patients on anticoagulant therapy when balancing the goals of EBP, safety, and efficacy. CASE REPORT: We present the case of a patient on anticoagulant therapy with low molecular weight heparin (LMWH) who presented for a planned cesarean section which was complicated by dural puncture with a Tuohy needle during combined spinal-epidural placement. She then developed a postdural puncture headache (PDPH) after restarting LMWH. After holding LMWH for 18 hours, an EBP was placed resulting in symptomatic relief; LMWH was restarted 12 hours later. However, her symptoms returned and EBP was repeated 78 hours after the initial blood patch, again with relief of symptoms. CONCLUSION: This case highlights the importance of EBP procedure timing in the setting of LMWH administration in order to maximize efficacy while minimizing neuraxial hematoma and venous thromboembolism risk. KEY WORDS: Epidural blood patch, postdural puncture headache, anticoagulation, efficacy, timing

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Section: Discussionmentioning

confidence: 99%