Regional anaesthesia in patients taking anticoagulant drugs

IF 0.2 Q4 ANESTHESIOLOGY Anaesthesia and Intensive Care Medicine Pub Date : 2024-11-01 DOI:10.1016/j.mpaic.2024.08.015
William L Malein, Calum RK Grant
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Abstract

Managing perioperative anticoagulation and antiplatelet medication is a daily challenge for anaesthetists. Balancing the risks of surgical bleeding and complications of regional anaesthesia must be weighed against time to theatre and the risk of perioperative thrombotic events. The anaesthetist is particularly concerned about compressive vertebral canal haematomas (VCH) which may occur following spinal, epidural or para-vertebral techniques. There is also concern about bleeding complications following peripheral nerve blockade. This article attempts to put the risk of these complications into context and references key international guidelines on peri-procedural management of the broad range of anticoagulant and antiplatelet medication in current use.
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服用抗凝药物患者的区域麻醉
管理围术期抗凝和抗血小板药物是麻醉师每天面临的挑战。在平衡手术出血风险和区域麻醉并发症的同时,还必须权衡手术时间和围术期血栓事件的风险。麻醉师尤其关注脊柱、硬膜外或椎旁技术后可能出现的压迫性椎管血肿(VCH)。外周神经阻滞术后的出血并发症也令人担忧。本文试图说明这些并发症的风险,并参考了目前使用的各种抗凝剂和抗血小板药物围手术期管理的主要国际指南。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
152
期刊介绍: Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.
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Editorial Board Contents Medical gases Spinal anaesthesia Premedication
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