A patient who received clopidogrel with an indwelling epidural catheter

作者：Hamburger Joshua; Hofer Ira S^*; Khelemsky Yury

来源：Journal of Clinical Anesthesia, 2014, 26(7): 577-580.

DOI：10.1016/j.jclinane.2014.05.008

• Clopidogrel
• Drug-eluting stent
• Thoracotomy

A patient with a drug-eluting stent placed 18 months earlier received a thoracic epidural for perioperative analgesic control as part of her thoracotomy. Postoperatively, the patient was started on clopidogrel for secondary prevention. After consultation with the Hematology service and a platelet function assay, the patient was transfused two pools of platelets and the epidural catheter was removed on postoperative day 4. The patient then underwent hourly neurologic checks for 24 hours and was discharged several days later without any negative sequelae. If neuraxial techniques and the need for clopidogrel prophylaxis come into direct conflict, vigilance is necessary for warning signs of epidural hematoma and platelet transfusion should be considered to reverse the effects of the drug.

• 出版日期2014-11