Large retroperitoneal haematoma: an unexpected complication of ilioinguinal nerve block for inguinal hernia repair

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

“…236,237,303,304,310,[321][322][323][324][325] In all patients with neurodeficits, neurologic recovery was complete within 6 to 12 months. Thus, while bleeding into a neurovascular sheath may result in significant decreases in hematocrit, the expandable nature of peripheral site may decrease the chance of irreversible neural ischemia.…”

“…In addition, there continue to be case reports of significant morbidity related to hematomas following peripheral nerve blockade in coagulopathic patients. 236,237,303,304 Idestrup et al 305 performed a prospective, observational study investigating the incidence of hematoma formation and subsequent neurovascular compromise in patients with femoral catheters who were started on rivaroxaban postoperatively. Rivaroxaban was administered daily, and the femoral catheter was removed 20 hours after the first dose.…”

Lower extremity regional anesthesia: essentials of our current understanding

“…Studies on anticoagulants have demonstrated that patients who are elderly, female, afflicted with hepatorenal dysfunction, or have a low body weight can display an exaggerated response to the effect of these drugs 304. Moreover, in the literature, reports of bleeding have occurred with the combination of anticoagulants possessing different mechanisms of action (eg, enoxaparin and aspirin,299 warfarin and aspirin301) or drugs with the same antiplatelet action (eg, dipyridamole and aspirin) 305. Thus, the performance of nerve blocks in patients receiving more than one anticoagulant is strongly discouraged 304…”

Peripheral regional anaesthesia and outcome: lessons learned from the last 10 years

“…Only one case report with a massive retroperitoneal haematoma after ilioinguinal nerve block for inguinal hernia repair as a severe complication has been published. 175 Nice to know. For patients after hernia repair, the use of ilioinguinal and iliohypogastric nerve blocks led to an earlier hospital discharge [median 18 h (range 14-26) vs 23 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26), P¼0.007, 169 mean 14.1 h (SD 1.5) vs 42.8 (5.3), P,0.001].…”