Bergqvist D, Lindblad B, Mätzsch T
Department of Surgery, Lund University, General Hospital, Malmö, Sweden.
Acta Anaesthesiol Scand. 1992 Oct;36(7):605-9. doi: 10.1111/j.1399-6576.1992.tb03529.x.
This article reviews the problem of bleeding in connection with epidural/spinal anaesthesia, with special emphasis on the use of low molecular weight heparins for thromboprophylaxis. There are methodological difficulties to studying the problem in a scientifically correct way because of the rarity of the complication. However, from the data in the literature there are no indications of an increased risk in using the combination of low molecular weight heparin in prophylactic doses and epidural/spinal anaesthesia. So far, there is only a single case report, of spinal haematoma, although low molecular weight heparins have been used in combination with epidural/spinal anaesthesia in at least 1,000,000 patients. In controlled studies, at least 10,000 patients have been given the combination without complications.
本文回顾了与硬膜外/脊髓麻醉相关的出血问题，特别强调了低分子量肝素在血栓预防中的应用。由于该并发症罕见，以科学正确的方式研究此问题存在方法学上的困难。然而，从文献数据来看，没有迹象表明预防性剂量的低分子量肝素与硬膜外/脊髓麻醉联合使用会增加风险。到目前为止，尽管至少有100万患者将低分子量肝素与硬膜外/脊髓麻醉联合使用，但仅有一例脊髓血肿的病例报告。在对照研究中，至少10000名患者接受了这种联合用药且未出现并发症。
