Removal of an Epidural Catheter in a Patient Receiving Ticagrelor: A Case Report.

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A&A Practice Pub Date : 2023-06-01 DOI:10.1213/XAA.0000000000001693

Harshal D Wagh, Prashant K Nair, Deepak B Bhushan

引用次数: 0

Abstract

We report a case of a patient who had a coronary angioplasty and received heparin, clopidogrel, and ticagrelor on the evening of bilateral total knee arthroplasties performed under combined spinal epidural anesthesia. After a multidisciplinary meeting, the epidural catheter was removed 5 days after the dose of clopidogrel. With the catheter still in place, ticagrelor was continued to prevent stent thrombosis. Removing an epidural catheter in a patient on antiplatelet therapy must be done after a risk-benefit assessment, multidisciplinary collaboration, and stringent neurologic monitoring. The focus should be on prevention of a spinal hematoma, and rapid diagnosis and treatment to optimize the neurologic outcome.

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替格瑞洛患者硬膜外导管拔除一例报告。

我们报告一例冠脉血管成形术的患者，在双侧全膝关节置换术的晚上接受肝素、氯吡格雷和替格瑞洛的联合脊髓硬膜外麻醉。在多学科会议后，在给予氯吡格雷5天后取出硬膜外导管。导管仍在，替格瑞洛继续预防支架血栓形成。在接受抗血小板治疗的患者中，移除硬膜外导管必须在风险-收益评估、多学科合作和严格的神经系统监测之后进行。重点应放在预防脊髓血肿，快速诊断和治疗，以优化神经系统预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.