@article{Zafar_Bakar Siddiq_Ur Rehman_Siddiq_Shah_2018, title={THROMBOPROPHYLAXIS IN PATIENTS WITH EPIDURAL ANALGESIA AFTER HIP OR KNEE ARTHROPLASTY: Thromboprophylaxis in Epidural Analgesia}, volume={68}, url={https://pafmj.org/PAFMJ/article/view/90}, abstractNote={<p><strong>Objective:</strong> To propose a management plan for prevention of enoxaparin-induced epidural hematoma in patients with indwelling epidural catheters<br><strong>Study Design:</strong> Cross sectional study.<br><strong>Place and Duration of Study: </strong>Department of Orthopaedics and Spine, Doctors Hospital & Medical Centre,Lahore, Pakistan, from Jan to Dec 2016.<br><strong>Material and Methods: </strong>Sixty-eight patients undergoing hip or knee arthroplasty met our inclusion criteria. All patients received postoperative epidural analgesia and concomitant thromboprophylaxis with enoxaparin.Epidural was placed/removed 24 hours after the last dose of enoxaparin. Subsequent dose of enoxaparin was given 8 hours after removal of catheter. Patients were monitored for development of neurologic deficit according to American Spinal Injury Association (ASIA) impairment scale (appendix) on daily basis until discharge.<br>Thereafter, patients were examined at 2 weeks postoperatively.<br><strong>Results: </strong>Of the Sixty-eight patients enrolled, 47 (69.1%) were females and 21 (30.8%) males. Hip arthroplasty was done in 25 (36.7%), unilateral knee arthroplasty in 32(47%) and bilateral knee arthroplasty in 11 (16.1%) patients.Maximum neurologic score was set at 102 which was satisfactorily achieved in all patients. No patient reported any new sensory or motor deficit after the index surgery.<br><strong>Conclusion: </strong>Low-molecular-weight heparin (enoxaparin) is safe for use in conjunction with indwelling epidural catheter if appropriate interval is provided for catheter insertion and removal.</p> <p> </p>}, number={4}, journal={Pakistan Armed Forces Medical Journal}, author={Zafar, Ahmed and Bakar Siddiq, Umair Abu and Ur Rehman, Hafeez and Siddiq, Abu Bakar and Shah, GA}, year={2018}, month={Aug.}, pages={822–26} }