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Anticlotting drugs and regional anaesthetic and analgesic techniques: comparative update of the safety recommendations

Published online by Cambridge University Press:  01 May 2007

J. V. Llau ,
J. De Andrés ,
C. Gomar ,
A. Gómez-Luque ,
F. Hidalgo  and
L. M. Torres
J. V. Llau*
Affiliation:
Hospital Clinico Universitario, Department of Anaesthesiology, Critical Care and Pain Therapy, Valencia, Spain
J. De Andrés
Affiliation:
ConsorcioHospital General Universitario, Department of Anaesthesiology, Critical Care and Pain Therapy, Valencia, Spain
C. Gomar
Affiliation:
Hospital Clínic, Department of Anaesthesiology, Critical Care and Pain Therapy, Barcelona, Spain
A. Gómez-Luque
Affiliation:
Hospital Clínico Universitario, Department of Anaesthesiology, Critical Care and Pain Therapy, Málaga, Spain
F. Hidalgo
Affiliation:
Clínica Universitaria de Navarra, Department of Anaesthesiology, Critical Care and Pain Therapy, Pamplona, Spain
L. M. Torres
Affiliation:
Hospital Puerta del Mar, Department of Anaesthesiology, Critical Care and Pain Therapy, Cádiz, Spain
*
Correspondence to: Juan V. Llau, Department of Anaesthesiology, Critical Care and Pain Therapy, Hospital Clínico Universitario, Avda. Blasco Ibáñez, 17, 46010, Valencia, Spain. E-mail: juanvllau@terra.es; Tel: +34 963862653; Fax: +34 963862644
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Summary

The wide use of anticlotting drugs by patients scheduled for surgery is a challenge for the anaesthesiologist when considering a regional anaesthesia technique. This practice seems safe if there is an appropriate management based on safety intervals established according to the pharmacology of the drug and the regional technique. Some anaesthesiology societies have published recommendations for the safe practice of regional anaesthesia with the simultaneous use of anticoagulants (heparin, low molecular weight heparins, oral anticoagulants (OA), fondaparinux and others) and antiplatelet agents (aspirin, clopidogrel, ticlopidine, argatroban and others). One of the most recent guidelines has been published by the Spanish Society of Anaesthesia and Critical Care. This article reviews these recommendations and compares them with others published in the last years. The recommendations are similar, but some interesting differences can be observed and need to be considered. A European consensus in this setting would probably be necessary.

Keywords

CONDUCTION ANAESTHESIAGUIDELINESHEPARINDRUG INTERACTIONSBLOOD COAGULATIONVENOUS THROMBOSIS, prophylaxisPLATELET AGGREGATION INHIBITORS
Type
Review
Information
European Journal of Anaesthesiology , Volume 24 , Issue 5 , May 2007 , pp. 387 - 398
Copyright
Copyright © European Society of Anaesthesiology 2006

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