Regional Anaesthesia and Antithrombotics

This article was published in:

Anaesthesia 2007, 62, pages 1154-60

Summary:

Peri-operative thrombotic complications are common especially after major orthopaedic surgery. Neuraxial anaesthetic techniques are often used in orthopaedic patients undergoing lower limb surgery, especially joint replacements. With regard to regional anaesthesia and antithrombotics, the balance between the benefits (prevention of venous thromboembolism) and risks (major bleeding and epidural haematoma) is very important. This article suggests that neuraxial anaesthetic management should be based on the pharmacokinetic properties of specific anticoagulants and that central neuraxial blocks should not be performed or catheters manipulated until at least two half-lives after the last injection of anticoagulant.

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