Lumbar sympathetic block and anticoagulant therapy are of value in the treatment of many vascular disorders. In general, a block is indicated if there is vasospasm, and anticoagulants are given if there is possibility of thrombosis. Not infrequently both vasospasm and thrombosis are present, as in some cases of thrombophlebitis, embolism, or traumatic injury of a blood vessel. In such instances, one is tempted to employ lumbar block and anticoagulant therapy together; this involves a risk that has not been emphasized adequately.
One death has been reported by O'Connor, Preston, and Theis1 in which a lumbar block used in combination with controlled anticoagulant therapy was a contributing factor. This was the case of an 80-year-old man suffering from frostbite of both lower extremities. This patient was treated with repeated bilateral blocks while receiving bishydroxycoumarin (Dicumarol) in controlled therapeutic doses. He died on the 11th day of treatment, and an
Hohf RP, Dye WS, Julian OC. DANGER OF LUMBAR SYMPATHETIC BLOCKS DURING ANTICOAGULANT THERAPY. JAMA. 1953;152(5):399-400. doi:10.1001/jama.1953.63690050001008