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Article: Delayed epidural catheter removal: the impact of postoperative coagulopathy

TitleDelayed epidural catheter removal: the impact of postoperative coagulopathy
Authors
Issue Date2004
PublisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.au
Citation
Anaesthesia and Intensive Care, 2004, v. 32 n. 5, p. 630-636 How to Cite?
AbstractA retrospective analysis of 413 patients who received postoperative epidural analgesia under a standardized protocol found that 84 (20%) had a duration of epidural catheterization of greater than four days. The most common reasons were significant pain (n=64, 15%) and coagulopathy (n=26, 6%). Risk factor analysis for coagulopathy showed an odds ratio of 10.1 (95% confidence interval 4.2-24.5) for prolonged epidural catheterization among patients undergoing hepatectomy. Magnetic resonance imaging, performed in four patients with clinical signs suggestive of epidural haematoma, was negative for a space-occupying lesion in all cases. Eleven patients developed fever and clinical signs suggestive of epidural catheter-related infection, necessitating early catheter removal. Sixteen patients had persistent lower limb weakness at 24 hours after catheter removal. The signs soon resolved in all except two, one of whom had neuropathy related to intraoperative positioning and the other preoperative weakness. Accidental epidural catheter dislodgement occurred in 29 patients (7%) and is potentially hazardous if coagulopathy is unresolved. The risk-benefit ratio and factors complicating catheter removal, especially coagulopathy, should be considered when deciding whether to use epidural techniques.
Persistent Identifierhttp://hdl.handle.net/10722/67286
ISSN
2015 Impact Factor: 1.283
2015 SCImago Journal Rankings: 0.488
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTsui, SLen_HK
dc.contributor.authorYong, BHen_HK
dc.contributor.authorNg, KFJen_HK
dc.contributor.authorYuen, TSTen_HK
dc.contributor.authorLi, CCFen_HK
dc.contributor.authorChui, KYen_HK
dc.date.accessioned2010-09-06T05:53:38Z-
dc.date.available2010-09-06T05:53:38Z-
dc.date.issued2004en_HK
dc.identifier.citationAnaesthesia and Intensive Care, 2004, v. 32 n. 5, p. 630-636en_HK
dc.identifier.issn0310-057Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/67286-
dc.description.abstractA retrospective analysis of 413 patients who received postoperative epidural analgesia under a standardized protocol found that 84 (20%) had a duration of epidural catheterization of greater than four days. The most common reasons were significant pain (n=64, 15%) and coagulopathy (n=26, 6%). Risk factor analysis for coagulopathy showed an odds ratio of 10.1 (95% confidence interval 4.2-24.5) for prolonged epidural catheterization among patients undergoing hepatectomy. Magnetic resonance imaging, performed in four patients with clinical signs suggestive of epidural haematoma, was negative for a space-occupying lesion in all cases. Eleven patients developed fever and clinical signs suggestive of epidural catheter-related infection, necessitating early catheter removal. Sixteen patients had persistent lower limb weakness at 24 hours after catheter removal. The signs soon resolved in all except two, one of whom had neuropathy related to intraoperative positioning and the other preoperative weakness. Accidental epidural catheter dislodgement occurred in 29 patients (7%) and is potentially hazardous if coagulopathy is unresolved. The risk-benefit ratio and factors complicating catheter removal, especially coagulopathy, should be considered when deciding whether to use epidural techniques.en_HK
dc.languageengen_HK
dc.publisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.auen_HK
dc.relation.ispartofAnaesthesia and Intensive Careen_HK
dc.subject.meshAnalgesia, Epidural - adverse effects - instrumentation - methodsen_HK
dc.subject.meshBlood Coagulation Disorders - epidemiology - etiologyen_HK
dc.subject.meshCatheterization - adverse effectsen_HK
dc.subject.meshDevice Removal - adverse effectsen_HK
dc.subject.meshPain, Postoperative - prevention and control - therapyen_HK
dc.titleDelayed epidural catheter removal: the impact of postoperative coagulopathyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0310-057X&volume=32&spage=630&epage=636&date=2004&atitle=Delayed+epidural+catheter+removal:+the+impact+of+postoperative+coagulopathyen_HK
dc.identifier.emailTsui, SL: sltsui@hkucc.hku.hken_HK
dc.identifier.emailYong, BH: bhyong@hku.hk-
dc.identifier.emailNg, KFJ: jkfng@hku.hk-
dc.identifier.authorityNg, KFJ=rp00544en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid15535484en_HK
dc.identifier.scopuseid_2-s2.0-7244232810en_HK
dc.identifier.hkuros97316en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-7244232810&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume32en_HK
dc.identifier.issue5en_HK
dc.identifier.spage630en_HK
dc.identifier.epage636en_HK
dc.identifier.isiWOS:000224708900003-
dc.publisher.placeAustraliaen_HK

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