Safety of spinal anesthesia in thrombocytopenic patients: are there lessons to be learnt from oncology?

Coagulation concerns in patients with COVID-19 proposed for regional anesthesia

“…1 A platelet count above 75,000/mL is an acceptable level for performing neuraxial techniques in obstetric patients. 3 In select circumstances of obstetric anesthesia, platelet count between 50 and 80,000/ mL may still allow neuraxial block. 3 The platelet count threshold for lumbar puncture is substantially below and the risk of spinal hematoma is very low in oncology patients.…”

“…3 In select circumstances of obstetric anesthesia, platelet count between 50 and 80,000/ mL may still allow neuraxial block. 3 The platelet count threshold for lumbar puncture is substantially below and the risk of spinal hematoma is very low in oncology patients. 3 Since a thinner needle is used and no catheter is placed at the epidural space, the risk of spinal hematoma after spinal anesthesia seems to be lower than after epidural catheterization.…”

“…3 The platelet count threshold for lumbar puncture is substantially below and the risk of spinal hematoma is very low in oncology patients. 3 Since a thinner needle is used and no catheter is placed at the epidural space, the risk of spinal hematoma after spinal anesthesia seems to be lower than after epidural catheterization. 3 When neuraxial procedure is considered desirable, thromboelastography may be useful in patients with worrisome thrombocytopenia.…”

“…3 Since a thinner needle is used and no catheter is placed at the epidural space, the risk of spinal hematoma after spinal anesthesia seems to be lower than after epidural catheterization. 3 When neuraxial procedure is considered desirable, thromboelastography may be useful in patients with worrisome thrombocytopenia. 3 In these cases, the decision to proceed with spinal anesthesia is a balance between benefits and risks for the patient.…”

“…3 When neuraxial procedure is considered desirable, thromboelastography may be useful in patients with worrisome thrombocytopenia. 3 In these cases, the decision to proceed with spinal anesthesia is a balance between benefits and risks for the patient. 3 COVID-19 coagulopathy seems to be prothrombotic.…”