Epidural in extremely elder
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Hi dears
I just had a patient yesterday (96) years old for whom I have done caudal epidural and SIJ steroid injection
I was wandering if anybody familiar with any specific extreme age recommendations for such a procedure.
Everything went well ( thanks to god) but I noticed that , of course the sacro-coccygeal membrane was calcific as expected but also the space was very vascular and it took me some trials to get a good dye spread (I had many intravascular dye spread for which I had to pull back and reposition my catheter again) -
Been there and done that, even in younger non failed surgery patients. Not aware of any age related increased vascularity or coagulopathy in the elderly. If anything is age related increased thrombosis due to increased fibrinogen and factor VII and factor VIII . As always want to take good history about any anticoagulants or herbal products that may effect hemostasis. As Gabor Racz always said to me : persistent vigilance and good luck! Do not weaken! Best, John W Nelson MD
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El paciente mas viejo que he tratado con bloqueo epidural ha sido de 98 años, en los bloqueos facetarios y los bloqueos radiculares mi paciente mas viejo ha sido de 96 años, quizá lo mas importante es definir la mejor técnica para evitar los menores riesgos, la guía radiológica, eco gráfica y electromiografica han sido el mejor recurso de control y con excelentes resultados
Original post translated to English: The oldest patient that I have treated with epidural block has been 98 years, in facet blocks and root blocks my oldest patient has been 96 years, perhaps the most important thing is to define the best technique to avoid the least risks, the Radiological guide, eco graph and electromyography have been the best control resource and with excellent results
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