I. Lowenwirt et al., ESSENTIAL THROMBOCYTHEMIA AND EPIDURAL ANALGESIA IN THE PARTURIENT - DOES THROMBOELASTOGRAPHY HELP, Regional anesthesia, 21(6), 1996, pp. 525-528
Background and Objectives. It is often considered that essential throm
bocythemia contraindicates placement of an epidural catheter because o
f the danger of epidural hematoma. Thromboelastography offers a possib
le means of determining the appropriateness of epidural analgesia in a
patient with this disorder. Methods. A pregnant woman with essential
thrombocythemia and a history of spontaneous abortions was evaluated b
y thromboelastography at 38 weeks of gestation to determine the safety
of using epidural analgesia for labor pain management. On the basis o
f the thermoelastography findings, the patient was given epidural anal
gesia with bupivacaine and fentanyl during her labor. Results. The pat
ient experienced good pain relief, delivered a healthy infant vaginall
y, and suffered no complications. Conclusions. Thromboelastography may
be a useful diagnostic test in determining the suitability of regiona
l techniques for labor analgesia in parturients with essential thrombo
cythemia. However, success in one patient does not prove the general s
afety of this approach.