ANTİTROMBOTİK KULLANAN HASTALARDA REJYONAL ANESTEZİ UYGULAMASI: KLAVUZLAR NE DİYOR ?

Suna Akın Takmaz; Hülya Başar; Bülent Baltacı

ANESTHETIC APPROACH IN PATIENTS USING ANTITHROMBOTIC AGENTS: WHAT THE GUIDELINES RECOMMEND ?

Year 2016, Volume: 49 Issue: 2, 114 - 121, 01.08.2016

Suna Akın Takmaz Hülya Başar Bülent Baltacı

Abstract

Number of patients who use antihrombotic agent and need surgical procedure is increasing in anesthesiology practice. Regional anesthetic management requires different attention and precision in patients using antithrombotic agent. The risks should be analysed carefully in patients either the drug is stopped or continued. In this manuscript, the actual guides created by international societies for regional anesthesia approach in patients using antithrombotic agents are summarized

Keywords

Regional anesthesia, anticoagulant treatment, antithrombotic treatment

References

)Stafford-Smith M. Impaired haemostasis and regional ana- esthesia. Can J Anaesth. 1996; 43: 129-41.
)Horlocker TT, Wedel DJ. Neuraxial block and low-mole- cular-weight heparin: balancing perioperative analgesia and thromboprophylaxis. Reg Anesth Pain Med. 1998; 23: 164-77
)Moen V, Dahlgren N, Irestedt L. Severe neurological comp- lications after central neuraxial blockades in Sweden 1990- Anesthesiology. 2004; 101: 950-9.
)Cook TM, Counsell D, Wildsmith JA; Royal College of Anaesthetists Third National Audit Project. Major complica- tions of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists. Br J Ana- esth. 2009; 102: 179-90.
)Vandermeulen E. Regional anaesthesia and anticoagulati- on. Best Pract Res Clin Anaesthesiol. 2010; 24: 121-31.
)Horlocker TT, Wedel DJ. Anticoagulation and neuraxial block: historical perspective, anesthetic implications, and risk management. Reg Anesth Pain Med. 1998; 23: 129-34
)Horlocker TT, Wedel DJ, Rowlingson JC, Enneking FK, Kopp SL, Benzon HT et all. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Eviden- ce-Based Guidelines (Third Edition). Reg Anesth Pain Med. ; 35: 64-101. )Gogarten W, Vandermeulen E, Van Aken H, Kozek S, Llau JV, Samama CM; European Scoeity of Anaesthesiology. Regi- onal anaesthesia and antithrombotic agents: recommendati- ons of the European Society of Anaesthesiology.Eur J Anaest- hesiol. 2010; 27: 999-1015
)Liu SS, Mulroy MF. Neuraxial anesthesia and analgesia in the presence of standard heparin. Reg Anesth Pain Med. ; 23: 157-63
)Ruff RL, Dougherty JH Jr. Stroke. Complications of lum- bar puncture followed by anticoagulation. 1981; 12: 879-81.
)Hemmerling TM, Cyr S, Terrasini N. Ann Card Anaesth. Epidural catheterization in cardiac surgery: the 2012 risk as- sessment. 2013; 16: 169-77.
)Burger W, Chemnitius JM, Kneissl GD, Rücker G. J Intern Med. Low-dose aspirin for secondary cardiovascular preven- tion-cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation - review and me- ta-analysis. 2005; 257: 399-414.
)Horlocker TT, Bajwa ZH, Ashraf Z, Khan S, Wilson JL, Sami N, Peeters-Asdourian C, Powers CA, Schroeder DR, Decker PA, Warfield CA. Risk assessment of hemorrhagic complications associated with nonsteroidal antiinflamma- tory medications in ambulatory pain clinic patients undergo- ing epidural steroid injection. Anesth Analg. 2002; 95: 1691-7
)Seow K, Drummond KJ. J Clin Neurosci. Subdural spinal haematoma after spinal anaesthesia in a patient taking aspi- rin. 2011; 18: 1713-5.
)Litz RJ, Gottschlich B, Stehr SN. Spinal epidural hemato- ma after spinal anesthesia in a patient treated with clopidog- rel and enoxaparin. Anesthesiology. 2004; 101: 1467-70.
)Tam NL, Pac-Soo C, Pretorius PM. Br J Anaesth. Epidural haematoma after a combined spinal-epidural anaesthetic in a patient treated with clopidogrel and dalteparin. 2006; 96: 5.