How should regional anesthesia be managed in patients receiving antithrombotic agents to minimize bleeding complications?
Provides European Society of Anaesthesiology recommendations for managing regional anesthesia in patients on antithrombotic agents to minimize bleeding risks.
in order to minimise bleeding complications during regional anaesthetic techniques, care should be taken to avoid traumatic puncture. If a bloody tap occurs when intraoperative anticoagulation is planned, postponing surgery should be considered. Alternatively, catheters can be placed the night before surgery. Regional anaesthesia in patients receiving full anticoagulation treatment continues to be contraindicated. Catheter manipulation and removal carry similar risks to insertion and the same criteria should apply. Appropriate neurological monitoring is essential during the postoperative recovery period and following catheter removal. The final decision to perform regional anaesthesia in patients receiving drugs that affect haemostasis has to be taken after careful assessment of individual risks and benefits.
Gogarten et al. (Fri,) studied this question.