Fifty-one cases were included.
Fifty-one confirmed spinal haematomas associated with epidural anaesthesia were identified, most of which were related to the insertion of a catheter, a procedure that was graded as difficult or traumatic in 21 patients. Other risk factors were: fibrinolytic therapy (n=2), previously unknown spinal pathology (n=2), low molecular weight heparin (n=2), aspirin or other non-steroidal anti-inflammatory drug (NSAID; n=3), epidural catheter inserted during general anaesthesia (n=3), thrombocytopenia (n=5), ankylosing spondylitis (n=5), pre-existing coagulopathy (n=14), and intravenous heparin therapy (n=18).
Analysis of reported clinical practice suggests an incidence of haematoma of 1 in 190,000 epidurals.