"Informed consent" bei geburtshilflicher Epiduralanalgesie

Contraindications to regional anaesthesia in obstetrics: a survey of German practice

“…The two levels were chosen because they both fell below the generally accepted safety threshold of 100 · 10 9 /L recommended in a German language publication. 4 However, nowadays many experienced anaesthetists would perform a regional block at platelet counts of 80 · 10 9 /L. The second value mentioned in the questionnaire was, however, lower than the 75 · 10 9 /L discussed in some publications.…”

“…But anti-platelet medication is designed to be antithrombotic rather than anticoagulant and low-dose aspirin is not usually considered a contraindication to regional anaesthesia, if no additional antithrombotic substances are administered and no further additional bleeding risks exist. 4,12,14,15 Low-dose aspirin does not appear to produce enhanced bleeding problems or increase the frequency of spinal haematoma. [16][17][18] A time interval of more than two days after the last intake is recommended in Germany, if additional prophylactic heparin is administered.…”

“…There is no consensus view in Germany at present on the minimum platelet count at which regional blocks can be performed safely. 4,5 Similarly, the use of regional anaesthesia is controversial in patients with placenta praevia in whom significant haemorrhage is likely or where there is chorioamnionitis and the possibility of infectious complications. Consequently we conducted a questionnaire to evaluate German anaesthetists' attitudes to the use of regional blocks in high-risk pregnancy.…”