RT Journal Article
SR Electronic
T1 The safe use of epidural anesthesia after subcutaneous injection of low-dose heparin in general abdominal surgery
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 289
OP 294
VO 43
IS 4
A1 Jeannine Kassis
A1 François Fugère
A1 Serge Dubé
YR 2000
UL http://canjsurg.ca/content/43/4/289.abstract
AB Objective: To determine if epidural anesthesia after the subcutaneous injection of low-dose unfractionated heparin (LDUH) in patients who undergo elective bowel surgery is safe with respect to hemorrhagic complications.Design: A prospective cohort study.Setting: Two hospitals affiliated with the Université de Montréal.Patients: Fifty patients scheduled for elective bowel surgery.Intervention: Subcutaneous injection of 5000 units of LDUH and elective surgery for colonic carcinoma, chronic diverticulosis or inflammatory bowel disease.Main outcome measures: Activated partial thromboplastin time (APTT), anti-IIa and anti-Xa heparin levels measured before and 2 and 4 hours after injection of LDUH.Results: In no case was the heparin anti-IIa or anti-Xa level higher than 0.20 U/mL, which is considered a significant detectable level of heparin.Conclusion: LDUH given subcutaneously is not associated with significant detectable heparin levels, so epidural anesthesia should be safe when performed 2 hours after LDUH injection in patients who undergo general abdominal surgery in the absence of any other impairment of hemostasis.