Anaesthesia and new antithrombotic drugs

Abstract

There is currently not enough information available to make any firm statements about the safety of combining regional anaesthesia and the new anticoagulant agents. Until such information becomes available, knowledge of the pharmacological profile of these drugs in terms of elimination half-life, the potential for thrombocytopenia and the availability of antagonizing drugs will help us to decide whether or not a major regional anaesthetic technique will be feasible in the individual patient treated with these new compounds.

Management of Chronic Medication Therapies in the Perioperative Period: a Literature Review

“…However, the same effect can help prevent perioperative vascular complications, particularly cardiac and thromboembolic events. Newer more potent antiplatelet agents have been developed, and recent reviews indicate that these newer agents offer greater efficacy and ease of administration, but are more difficult to monitor or reverse, increasing the adverse implications of residual drug levels [10].…”

Epidural Anesthesia Improves Outcome and Resource Use in Cardiac Surgery: A Single-Center Study of a 1293-Patient Cohort

“…Despite more than 50 years of experience [Clowes 1954], there is a fear of perimedullary hematoma or neurologic complications following epidural catheter placement in patients who will receive anticoagulation therapy. With an experienced operator performing the placement of the epidural catheter according to strict guidelines [Horlocker 2003;Vandermeulen 2005], the risks can be minimized. The anesthesiologist and the surgeons have to accept the possibility of postponing the surgery if a "bloody tap" occurs.…”