Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

Horlocker, Terese T.; Vandermeuelen, Erik; Kopp, Sandra L.; Gogarten, W.; Leffert, Lisa; Benzon, Honorio T.

doi:10.1097/aap.0000000000000763

Cited by 741 publications

(155 citation statements)

References 326 publications

(352 reference statements)

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“…The fourth edition of the American Society of Regional Anaesthesia guidelines are under review. The current edition recognises that the risk of complications is higher with deep blocks, such as lumbar plexus or paravertebral blocks, in patients receiving anticoagulant medication compared with more peripheral blocks, but states that recommendations regarding neuraxial techniques should be applied to all these patients [2]. A recently updated Cochrane systematic review [4] demonstrated improved safety and accuracy of ultrasound-guided regional limb blocks compared with peripheral nerve stimulation, including a reduced rate of accidental vascular puncture.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound‐guided popliteal nerve blocks in a high risk patient for bilateral foot amputations on dual anti‐platelet therapy

McLoughlin

Turbitt

2016

Anaesthesia Cases

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We present the case of an ASA physical status 4 patient, receiving dual anti-platelet therapy, in whom bilateral ultrasound-guided popliteal nerve blocks were performed for surgical anaesthesia during bilateral trans-metatarsal amputations. The potential complications of central neuraxial blockade or general anaesthesia with opioid administration were avoided in this patient with the use of ultrasound-guided peripheral nerve blocks. No bleeding or neurological complications occurred.

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Section: Discussionmentioning

confidence: 99%

“…Several guidelines [1,2] are available which provide advice on the safety of performing regional anaesthetic techniques in patients receiving anticoagulants. However, as these recommendations are mainly based on the risks and complications of central neuraxial techniques, it becomes difficult to apply them to peripheral nerve blockades.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound‐guided popliteal nerve blocks in a high risk patient for bilateral foot amputations on dual anti‐platelet therapy

McLoughlin

Turbitt

2016

Anaesthesia Cases

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“…It is also often the choice for anaesthesia during labour, because it contributes to minimising the urge to bear down before complete cervical dilation and decreases circulating catecholamines. [29] If the patient is on anticoagulation, it is crucial to evaluate the specific drug, dosage and time since administration before neuraxial anaesthesia.…”

Section: Managing Neuraxial Anaesthesiamentioning

confidence: 99%

Venous thromboembolism in pregnancy

Wessels

2019

S Afr Med J

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“…If there is needed, a regional anesthesia should be performed 10-12 h after the last prophylactic dose of LMWH and 24 h after the last therapeutic dose of LMWH. If there are used prophylactic UFH doses (5000 units twice daily), regional anesthesia can be safely placed, but in cases which require higher doses (10,000 units twice daily or greater), an individual assessment is usually necessary [65][66][67].…”

Section: Prevention Of Seizuresmentioning

confidence: 99%

Cerebral Vein and Dural Sinus Thrombosis

Jianu¹,

Jianu²,

Munteanu³

et al. 2018

Ischemic Stroke of Brain

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Cerebral venous thrombosis (CVT) is an uncommon disorder in the general population. At least 1 risk factor can be identified in 85% of patients with CVT. Because of the high frequency of thrombophilia among patients with CVT, screening for hypercoagulable conditions should be performed. Two pathophysiological mechanisms contribute to their highly variable clinical presentation. Four major syndromes have been described: isolated intracranial hypertension, focal neurological abnormalities, seizures, and encephalopathy. Cavernous sinus thrombosis represents the single CVT which produces a characteristic clinical syndrome. Head Computed Tomography is the most frequently performed imaging study, but Magnetic Resonance Imaging of the head combined with Magnetic Resonance venography are the most sensitive studies. Acute phase therapy for CVT focuses on anticoagulation, management of seizures, increased intracranial pressure, and prevention of cerebral herniation. The majority of patients have a complete or partial recovery, however they have an increased incidence of venous thromboembolism. Clinical and imaging follow-ups 3-6 months after diagnosis are recommended to assess for recanalization.

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Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

Cited by 741 publications

References 326 publications

Ultrasound‐guided popliteal nerve blocks in a high risk patient for bilateral foot amputations on dual anti‐platelet therapy

Ultrasound‐guided popliteal nerve blocks in a high risk patient for bilateral foot amputations on dual anti‐platelet therapy

Venous thromboembolism in pregnancy

Cerebral Vein and Dural Sinus Thrombosis

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