Can epidural anesthesia and warfarin be coadministered?
Parvizi J; Viscusi ER; Frank HG; Sharkey PF; Hozack WJ; Rothman RR Rothman Institute of Orthopedics, Department of Anesthesia, Thomas Jefferson University, Philadelphia, PA 19107, USA. parvj@aol.com Epidural hypotensive anesthesia can, in addition to imparting numerous intraoperative benefits, provide excellent postoperative pain control for patients having joint arthroplasties. However, because of the risk of epidural hematoma, epidural anesthesia is not coadministered with anticoagulation in some centers. We retrospectively ascertained, by chart review, the incidence of epidural hematoma in 11,235 patients having 12,991 knee arthroplasties at our institution who received oral anticoagulation and epidural anesthesia for their surgery. Warfarin was administered on the day of surgery. With the exception of 212 patients, the epidural catheter was removed within 48 hours of surgery. Based on clinical examinations, we detected no epidural hematomas. For 1030 patients (1038 knees) whose cha
