{
  "abstract": "Application for ESRA Abstract Prizes:Background and Aims Spinal haematoma is a rare but potentially severe complication of regional anaesthesia. The incidence of multicompartmental haematomas - involving the epidural, subdural and subarachnoid spaces - is even lower, especially after a single shot spinal anaesthesia. We present a case of a patient with renal impairment and aim to highlight the need for anticoagulation regimen optimization and timely management of such haematomas.Methods Our 79-year-old female patient underwent femoral fracture surgery. She had type II diabetes mellitus and impaired kidney function with a mean GFR value of 37.1. Perioperative platelet count and coagulation tests were normal. Prophylactic bemiparin dose was administered 24 hours before and 12 hours after spinal anaesthesia. A 25G pencil-point needle was successfully inserted on the first try in the L3–4 subarachnoid space. CSF flow was free and clear. Following injection of 2.7 ml of ropivacaine 0.75%, T10 sensory block was achieved and the surgery proceeded uneventfully. Four hours later she completely recovered from anaesthesia.Results Acute low back pain was reported 32 h later and paraplegia was progressively established. Urgent MRI scan revealed an epi-/subdural haematoma from T11 to L4, along with subarachnoid extention. Although decompressive laminectomy was immediately performed, only minor motor improvement was attained and she remains wheelchair-dependent. Subsequent angiography showed no vascular malformations.Abstract P294 Figure 1Subdural part of the haematoma-intraoperative imageAbstract P294 Figure 2Subdural/epidural haematoma(open arrow) and spinal cord oedema(closed arrow)Conclusions Considering the normal coagulation profile, single-puncture technique and lack of other risk factors, we suspect bemiparine prolongation due to renal impairment. Therefore, renal function should be carefully assessed and anticoagulation appropriately managed. Lastly, prompt diagnosis and surgery are paramount to patient prognosis.",
  "authors": [
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Dimitrios Stathatos"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Andriani Pittara"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Kalliopi Chatzistavrou"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Despoina - Fani Papadaki"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Athanasia Georgaki"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Panagiotis Sotiriadis"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Michail Navrozidis"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Genaral Hospital of Athens, Korgialenieo-Benakeio, Athens, Greece"
      ],
      "name": "Panagiotis Georgakis"
    }
  ],
  "title": "P294 Poster: multicompartmental spinal haematoma after a single shot spinal anaesthesia – a case report",
  "uid": "52a66c9f-11d3-5a9b-8f7b-40cc39629b0a"
}