Anasthesiologie & intensivmedizin
Author:
Keywords:
anaesthesia, epidural, anaesthesia, spinal, thromboembolism, anticoagulants, hemorrhage, molecular-weight heparin, preoperative antiplatelet therapy, epidural-anesthesia, anticoagulant-therapy, spinal hematoma, surgery, risk, prevention, experience, analgesia, Science & Technology, Life Sciences & Biomedicine, Anesthesiology, Critical Care Medicine, General & Internal Medicine, MOLECULAR-WEIGHT HEPARIN, PREOPERATIVE ANTIPLATELET THERAPY, EPIDURAL-ANESTHESIA, ANTICOAGULANT-THERAPY, SPINAL HEMATOMA, SURGERY, RISK, PREVENTION, EXPERIENCE, ANALGESIA, 1103 Clinical Sciences, 3202 Clinical sciences
Abstract:
Performing regional anaesthetics in patients who have or will receive some form of anticoagulation is still discussed controversially. However, spinal or epidural anaesthesia is considered safe during low-dose therapy with unfractioned or low molecular weight heparins as long as the following time intervals between administration of heparin and spinal/epidural puncture or removal of the catheter are carefully taken into account, After unfractioned heparin, placement of a needle or catheter and removal of the epidural catheter should be delayed for 4 hours, A subsequent injection of unfractioned heparin can be administered after 1 hour, This includes intraoperative intravenous full heparinisation, provided ACT is carefully monitored,