AI Article Synopsis
- - A 45-year-old male underwent thoracotomy for empyema and received several doses of intrapleural rtPA, a clot-dissolving medication.
- - To ensure safe administration of regional anesthesia, the acute pain service conducted a ROTEM test, revealing normal clotting parameters and no significant effects from the rtPA.
- - The findings allowed for a successful single-shot paravertebral block and subsequent thoracic epidural, demonstrating ROTEM's effectiveness in assessing coagulation status in patients treated with rtPA.
Article Abstract
We report a case of a 45-year-old male who underwent thoracotomy for empyema and received multiple doses of intrapleural recombinant tissue plasminogen activator (rtPA). Given the recent administration of rtPA, the acute pain service performed a rotational thromboelastometry (ROTEM) test to assess coagulation before proceeding with regional anesthesia. The ROTEM results indicated normal to hypercoagulable clotting parameters, with a normal extrinsic thromboelastometry (EXTEM) lysis index at 30 minutes, suggesting no systemic effects of rtPA. Based on these findings, a single-shot paravertebral block was successfully performed, and subsequent pain management included a thoracic epidural without complication or evidence of spinal hematoma. This case demonstrates that ROTEM can provide valuable reassurance on coagulation status in patients who have received intrapleural rtPA, helping to assess the safety of regional anesthesia.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633844 | PMC |
| http://dx.doi.org/10.7759/cureus.75547 | DOI Listing |
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