Epidural hematoma after total knee arthroplasty in a patient receiving rivaroxaban: A case report.
10.17085/apm.2019.14.1.102
- Author:
Sojin SHIN
1
;
Hyoseok KANG
;
Jae Woo LEE
;
Hyoung gyun KIM
;
Eun su CHOI
Author Information
1. Department of Anesthesiology and Pain Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea. potterydoll@gmail.com
- Publication Type:Case Report
- Keywords:
Anticoagulants;
Conduction anesthesia;
Spinal epidural hematoma
- MeSH:
Aged;
Anesthesia, Conduction;
Anesthesia, Epidural;
Anticoagulants;
Appointments and Schedules;
Arthroplasty, Replacement, Knee*;
Factor Xa;
Hematoma*;
Hematoma, Epidural, Spinal;
Humans;
Orthopedics;
Pulmonary Embolism;
Rivaroxaban*
- From:Anesthesia and Pain Medicine
2019;14(1):102-105
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rivaroxaban, a factor Xa inhibitor, is one of the newly developed direct oral anticoagulants (DOAC). In recent times, it has been increasingly used in the prevention of pulmonary embolism in patients undergoing orthopedic surgery. This report describes a case of epidural hematoma in an elderly patient who underwent combined spinal epidural anesthesia for total knee arthroplasty; the patient received rivaroxaban postoperatively for 7 days to prevent pulmonary embolism. Additionally, the epidural hematomas developed on the 5th postoperative day but the patient recovered well with conservative treatment. Although rivaroxaban has a low need for monitoring and is easily administered, the guidelines should be carefully checked for the postoperative administration schedule in patients undergoing regional anesthesia. In addition, rivaroxaban should be used with caution, especially in elderly patients.
