Reply to how common is it for the anesthesiologist to refuse to give an epidural?

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Reply to "how common is it for the anesthesiologist to refuse to give an epidural?"

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[quote=Anonymous][quote=Anonymous]I had HELLP syndrome with #1 and got a range of 50K when anesthesiologists were asked what their absolute platelet cutoff for a spinal was. (I was going into an emergency c-section, so the alternative was GA not just unmedicated birth.) The hospital said the cutoff for residents/fellows to perform with assistance was 100K and that attendings had their own cutoffs between 50K and 100K. (The platelet test is performed up to an hour the c-section and in the case of HELLP, platelets often keep falling rapidly, so some wiggle room is built in. Apparently in a stable platelets scenario, some doctors will go as low as 25K.) Anyway, the on-call doc had a cut off of 75K and it was a hairsbreath from being an issue, because my platelets came back at 75K on the dot. If they'd come back at between 50K and 75K, we were going to try to make a stink, because GA is bad for the baby. In any case, luckily we didn't have to and the blood tests at delivery (about 35 minutes post-the original blood test in my case) later came back at 57K, so they were falling fast and I got really lucky to avoid a fight/GA.[/quote]

Platelets can be a real issue. The risk of epidural with platelets too low is that you continue bleeding and put pressure on the spinal cord, causing potentially permanent paralysis.[/quote]

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