抗凝与神经轴/外周麻醉。

Anticoagulation and Neuraxial/Peripheral Anesthesia.

作者信息

Kaushal Mudit, Rubin Ryan E, Kaye Alan D, Gritsenko Karina

机构信息

Department of Anesthesiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.

Department of Anesthesiology, Louisiana State University School of Medicine, 1542 Tulane Avenue, Room 658, New Orleans, LA 70112, USA.

出版信息

Anesthesiol Clin. 2017 Jun;35(2):e21-e39. doi: 10.1016/j.anclin.2017.01.002.

DOI:10.1016/j.anclin.2017.01.002

PMID:28526159

Abstract

Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable reference for the clinician who is met with these challenges. In addition to discussing NAGs, we also review the existing American Society of Regional Anesthesia guidelines for heparin, low-molecular-weight heparin, and antiplatelet agents.

摘要

新型抗凝剂（NAGs）已成为维生素K拮抗剂的首选替代药物。对于考虑接受区域麻醉的患者，这些药物在术前评估中带来了一层复杂性。目前尚无既定的检测方法来监测抗凝活性，而且我们对这些药物的经验尚短。这些作者认为，回顾相关的血液学、骨科和麻醉学文献，对于面临这些挑战的临床医生而言提供有价值的参考很重要。除了讨论新型抗凝剂外，我们还回顾了美国区域麻醉学会关于肝素、低分子肝素和抗血小板药物的现有指南。