You are considering placing an epidural in your patient whose platelet count is 76,000 × 106/L. According to a recent meta-analysis, which of the following is MOST likely true regarding the complication of spinal epidural hematoma after lumbar neuraxial procedures in thrombocytopenic patients?
The decision of whether to perform a neuraxial anesthetic procedure in a thrombocytopenic patient has serious implications. Avoiding regional anesthesia can result in decreased postoperative analgesia, with increased opioid requirements leading to increased occurrence of ileus, pruritus, urinary retention, and nausea/vomiting. In the obstetric population, performing general anesthesia instead of neuraxial anesthesia increases the risk of failed maternal intubation, poor postoperative analgesia, and increased risk of fetal exposure to anesthetic agents. However, the risks associated with performing neuraxial procedures in thrombocytopenic patients cannot be overlooked. The development of a spinal epidural hematoma after a neuraxial procedure in a thrombocytopenic patient can result in severe weakness,...
