Central nerve block and thromboprophylaxis

Dolenska, Sylva

doi:10.1093/bja/83.3.534-a

Cited by 1 publication

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“…non‐steroidal anti‐inflammatory drugs or other antiplatelet agents). Other possible risk factors include older age, female gender and the presence of spinal column anomalies [25–27]. The risk of neurological dysfunction following haemorrhagic complications of central neuraxial anaesthesia in patients with normal anticoagulation is estimated to be <1 in 150 000 for epidural injection and 1 in 220 000 for spinal injection [28].…”

Section: Anaesthesia In Relation To Anticoagulation In Elective Orthomentioning

confidence: 99%

Ximelagatran, a new oral direct thrombin inhibitor, for the prevention of venous thromboembolic events in major elective orthopaedic surgery. Efficacy, safety and anaesthetic considerations

Rosencher¹

2004

Anaesthesia

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SummaryThe oral direct thrombin inhibitor ximelagatran shows great promise for prevention of venous thromboembolic events following major elective orthopaedic surgery. Its consistent and predictable pharmacokinetics and pharmacodynamics across a wide range of patient populations allow administration with fixed dosing and with no coagulation monitoring. In orthopaedic surgery clinical trials, ximelagatran was effective and well tolerated compared with standard therapy, with dose and timing relative to surgery important factors in determining its optimal profile. In European trials, an initial 3-mg postoperative dose of subcutaneous melagatran, the active form of ximelagatran, followed by oral ximelagatran 24 mg twice daily achieved similar efficacy and safety to enoxaparin. Although the risk of spinal haematoma following neuraxial anaesthesia is rare, it is increased by the concomitant use of anticoagulants. In orthopaedic surgery trials with ximelagatran to date, complications such as spinal haematoma have not been reported. The pharmacokinetic profile of ximelagatran suggests that concurrent use with neuraxial anaesthesia should require no further precautions than those currently necessary with low-molecular-weight heparin.

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Section: Anaesthesia In Relation To Anticoagulation In Elective Orthomentioning

confidence: 99%

Ximelagatran, a new oral direct thrombin inhibitor, for the prevention of venous thromboembolic events in major elective orthopaedic surgery. Efficacy, safety and anaesthetic considerations

Rosencher¹

2004

Anaesthesia

View full text Add to dashboard Cite

show abstract

Central nerve block and thromboprophylaxis

Cited by 1 publication

References 0 publications

Ximelagatran, a new oral direct thrombin inhibitor, for the prevention of venous thromboembolic events in major elective orthopaedic surgery. Efficacy, safety and anaesthetic considerations

Ximelagatran, a new oral direct thrombin inhibitor, for the prevention of venous thromboembolic events in major elective orthopaedic surgery. Efficacy, safety and anaesthetic considerations

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