SPINAL SUBDURAL BLEEDING AFTER ATTEMPTED EPIDURAL AND SUBSEQUENT SPINAL-ANESTHESIA IN A PATIENT ON THROMBOPROPHYLAXIS WITH LOW-MOLECULAR-WEIGHT HEPARIN

Despite the extensive use of low molecular weight heparins (LMWH) for thromboprophylaxis, only two serious complications have thus far been reported where spinal haematomas were incurred after epidural and spin al blocks in patients on such treatment. In our patient, who was on th romboprophylaxis with the LMWH drug enoxaparin, catheter epidural anae sthesia was abandoned due to a bloody tap and superseded by spinal ana esthesia. More than 40 hours later she had developed a paraparesis and complete sensory loss in the lower extremities. The MRT image showed haematomas epi- and subdurally, as well as subarachnoidally, but no ep idural bleeding was seen at laminectomy.