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What is Not a contraindication for combined spinal and epidural anaesthesia: (CSE) (D. REPEAT 2009) and explain in detail?
Ref: Ajar Yadav, Short Textbook of Anaesthesia, 1st edition. Page 125 and Miller Textbook of Anaesthesia, 6th edition, Page 1654Explanation:Patients on single antiplatelet drug is not a contraindication to central neuraxial blockade, whereas patients on multiple antiplatelet drugs are contraindicated for neuraxial anaesthesia.Patients on Anticoagulants, Fibrinolytic agents and Thrombocytopenia (platelet count <80.000) are at risk of bleeding and neuraxial hematoma with a possibility of spinal cord compression.Such patients are contraindicated for neuraxial anaesthesia.Patients with raised intracranial pressure carry a risk of coning of the brainstem and death. Such patients are contraindicated for neuraxial anaesthesia.CONTRAINDICATIONS FOR CENTRINEU-RAXIAL ANAESTHESIAAbsolute ContraindicationsRaised intracranial tension.Shock.Severe stenotic valvular heart disease.Marked skin infection.Severe spinal deformity.Blood dyscrasias.Anticoagulants.Multiple antiplatelet drugs.Relative ContraindicationsPre-existing neurological deficit.Sepsis.Spinal deformity.Pregnancy induced hypertension.Platelet count < 80,000.Impaired coagulation.Fibrinolytic agents.