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Epidural hematoma after total knee arthroplasty in a patient receiving rivaroxaban - A case report -
Anesth Pain Med 2019;14(1):102-5
Published online January 31, 2019
© 2019 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Sojin Shin , Hyoseok Kang , Jae Woo Lee , Hyoung-gyun Kim , and Eun-su Choi
Department of Anesthesiology and Pain Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
Correspondence to: Corresponding author Eun-su Choi, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea Tel: 82-2-970-8084 Fax: 82-2-970-8862 E-mail: potterydoll@gmail.com
Received May 4, 2018; Accepted June 26, 2018.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

Rivaroxaban, a factor Xa inhibitor, is one of the newly developed direct oral anticoagulants (DOAC). In recent times, it has been increasingly used in the prevention of pulmonary embolism in patients undergoing orthopedic surgery. This report describes a case of epidural hematoma in an elderly patient who underwent combined spinal epidural anesthesia for total knee arthroplasty; the patient received rivaroxaban postoperatively for 7 days to prevent pulmonary embolism. Additionally, the epidural hematomas developed on the 5th postoperative day but the patient recovered well with conservative treatment. Although rivaroxaban has a low need for monitoring and is easily administered, the guidelines should be carefully checked for the postoperative administration schedule in patients undergoing regional anesthesia. In addition, rivaroxaban should be used with caution, especially in elderly patients.

Key Words : Anticoagulants, Conduction anesthesia, Spinal epidural hematoma


April 2019, 14 (2)
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