Llau J V, De Andrés J, Gomar C, Gómez-Luque A, Hidalgo F, Torres L M
Hospital Clinico Universitario, Department of Anaesthesiology, Critical Care and Pain Therapy, Valencia, Spain.
Eur J Anaesthesiol. 2007 May;24(5):387-98. doi: 10.1017/S0265021506001918. Epub 2007 Jan 8.
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.
对于计划接受手术的患者而言,在考虑采用区域麻醉技术时,其广泛使用抗凝血药物对麻醉医生来说是一项挑战。如果根据药物药理学和区域技术确定的安全间隔进行适当管理,这种做法似乎是安全的。一些麻醉学会已经发布了关于同时使用抗凝剂(肝素、低分子肝素、口服抗凝剂(OA)、磺达肝癸钠等)和抗血小板药物(阿司匹林、氯吡格雷、噻氯匹定、阿加曲班等)进行区域麻醉的安全操作建议。西班牙麻醉与重症监护学会发布了最新的指南之一。本文回顾了这些建议,并将它们与过去几年发布的其他建议进行比较。这些建议相似,但可以观察到一些有趣的差异,需要加以考虑。在这种情况下,欧洲可能需要达成共识。