Louville Y, Cazalaà J B
Département d'anesthésie-réanimation chirurgicale, Hôpital Necker, Paris.
Agressologie. 1990 Mar;31(3):160-3.
Non traumatic spinal hematomas are a rare pathology, anticoagulant treatments are one of their most frequent etiology. Therefore, the association of spinal anesthesia and a preventive treatment which has antithrombotic aim by the use of subcutaneous heparin (non fragmented or low molecular weight) is being discussed by many authors. It is lawful to associate spinal anesthesia with a soft dose of non fragmented subcutaneous heparin (Kakkar method) if the protocols are strictly respected. It is certainly possible to use low molecular weight subcutaneous heparin as well. However a slight decline in their use urges anyone to be very cautious.
非创伤性脊柱血肿是一种罕见的病理情况,抗凝治疗是其最常见的病因之一。因此,许多作者正在讨论脊髓麻醉与通过使用皮下肝素(普通肝素或低分子量肝素)进行抗血栓预防治疗的联合应用。如果严格遵守方案,将脊髓麻醉与小剂量普通皮下肝素(卡卡尔法)联合应用是合理的。当然也可以使用低分子量皮下肝素。然而,其使用略有下降促使每个人都要非常谨慎。