Masui. The Japanese journal of anesthesiology
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Spinal hematoma is a rare and serious complication anesthesia. Risk factors for spinal hematoma during neuraxial anesthesia are anatomic abnormalities, impaired hemostasis and difficult needle placement. ⋯ In order to reduce the risk of spinal hematoma in patients receiving heparin, it is recommended that the needle placement and catheter removal should be done when the anticoagulant effect of heparin is at the minimum. Postoperative evaluation of the neurological status is also important for early detection of a spinal hematoma.
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Knowledge and information were acquired from the results of the annual perioperative pulmonary thromboembolism (PPT) research from 2002 to 2004 by the Japanese Society of Anesthesiologists. Due to the popularization and use of prophylaxis, perioperative pulmonary thromboembolism (PPT) decreased significantly in 2004 compared to the years 2002 and 2003 (P < 0.001). The types of surgery with the highest incidence of PPT were hip/extremity surgery (7.48 per 10,000 cases), spinal surgery (6.30 per 10000 cases) and laparotomy (5.32 per 10,000 cases). ⋯ The proportion of obese men (20-40 yrs) with PPT was 2 fold higher, and in women (20-50 yrs) it was three fold higher, than that of the general population. In our investigation, the mortality rate of the PPT patient without prophylaxis was significantly higher than that of the patient with prophylaxis (P < 0.01). The predictive factors for death in our logistic regression were male gender, immobility, and lack of prophylactic treatment.