Improving safety: Neuraxial blockade guided by thromboelastography for patients with uncertain coagulation profile.

Journal of postgraduate medicine Pub Date : 2024-07-01 Epub Date: 2024-08-14 DOI:10.4103/jpgm.jpgm_361_24
A Kumar, A N Deshmukh, C K Pandey, N Chaudhary
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Abstract

Abstract: Neuraxial blockade procedures are essential for anesthesia and pain management but pose risks in patients with uncertain coagulation profiles. Traditional coagulation tests often fail to predict bleeding risks associated with neuraxial blockade. Thromboelastography (TEG) offers real-time insights into coagulation status, potentially improving safety outcomes. In this case series, six patients underwent neuraxial blockade guided by TEG analysis. An individualized anesthetic plan was formulated based on TEG findings to mitigate bleeding risks while ensuring pain management. Tailoring anesthetic techniques to real-time TEG data improved safety outcomes with minimized bleeding complications and satisfactory pain control. In conclusion, neuraxial blockade guided by TEG enhances safety in patients with uncertain coagulation profiles. Further studies are needed to validate benefits in broader clinical settings.

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提高安全性:为凝血功能不确定的患者提供血栓弹力图引导下的神经阻滞。
摘要:神经阻滞手术对麻醉和疼痛治疗至关重要,但对凝血功能不确定的患者而言却存在风险。传统的凝血测试往往无法预测神经阻滞相关的出血风险。血栓弹性成像(TEG)可实时了解凝血状态,从而改善安全结果。在本病例系列中,六名患者在 TEG 分析的指导下接受了神经阻滞。根据 TEG 分析结果制定了个性化的麻醉计划,以降低出血风险,同时确保疼痛控制。根据实时 TEG 数据调整麻醉技术提高了安全性,最大限度地减少了出血并发症,疼痛控制令人满意。总之,在 TEG 指导下进行神经阻滞可提高凝血功能不确定患者的安全性。还需要进一步的研究来验证在更广泛的临床环境中的益处。
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