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首页> 外文期刊>Current opinion in anaesthesiology >Regional anesthesia and anticoagulation
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Regional anesthesia and anticoagulation

机译：区域麻醉和抗凝

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Patients receiving perioperative anticoagulation are a challenge for anesthesiologists when regional anesthesia would be a beneficial component of the anesthetic plan. Newly approved antithrombotic drugs maintain the need for updated review articles and recommendations.Due to the very low incidence of bleeding complications, guidelines are solely based on retrospective analyses of case reports and pharmacological considerations. Hence, they should not be taken as evidence-based 'cook books'. Recommendations of well established anticoagulants like heparin and non-steroidal antiinflammatory drugs may have a solid basis. However, the lack of data on new antithrombotic drugs including GII/GIIIA antagonists, factor X and thrombin-inhibitors requires a more conservative approach when regional anesthesia is considered. Current literature emphasizes postoperative monitoring; clear recommendations of its performance, however, are missing.Decisions to perform regional anesthesia in patients under anticoagulation should always be made on an individual risk-benefit assessment. A vigilant preoperative evaluation of the patient's medication and physical findings are as important as awareness of postoperative plans for anticoagulation.
机译：当区域麻醉将是麻醉计划的有益组成部分时，接受围手术期抗凝治疗的患者对于麻醉医师是一个挑战。新批准的抗血栓药物仍然需要更新的综述文章和建议。由于出血并发症的发生率非常低，因此指南仅基于病例报告的回顾性分析和药理学考虑。因此，不应将它们视为基于证据的“烹饪书”。完善的抗凝剂（例如肝素和非甾体类抗炎药）的建议可能具有坚实的基础。但是，在考虑区域麻醉时，缺乏有关新型抗血栓药物（包括GII / GIIIA拮抗剂，X因子和凝血酶抑制剂）的数据，需要采取更为保守的方法。当前文献强调术后监测。但是，尚缺乏有关其性能的明确建议。应始终根据个人风险获益评估来决定是否在抗凝患者中进行区域麻醉。对患者的药物和体格检查进行警惕的术前评估与了解术后抗凝计划一样重要。

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