Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA.
Department of Anesthesiology, LSU Health New Orleans, 1542 Tulane Ave, New Orleans, LA, 70112, USA.
Curr Pain Headache Rep. 2019 Jul 29;23(9):67. doi: 10.1007/s11916-019-0805-x.
Anticoagulant use among patients is prevalent and increasing. It is important for anesthesiologists to be aware of patients on anticoagulants while performing regional anesthesia.
In recent years, the FDA has approved many new anticoagulants. With new drugs coming to the market, new side effect profiles should be considered when treating patients, especially when using regional anesthesia. Both ASRA and European agencies have laid out recommendations regarding anticoagulant use and neuraxial/regional techniques. Regarding newer anticoagulants, the guidelines for discontinuation prior to neuraxial injection are based on pharmacokinetics, including half-life duration for each drug. While each clinical scenario requires an individualized approach, general guidelines can serve as a starting point to help with anesthetic planning and potentially improve patient safety in this evolving field.
接受抗凝治疗的患者较为普遍且呈上升趋势。麻醉医生在实施区域麻醉时了解患者的抗凝情况非常重要。
近年来，美国食品药品监督管理局已批准多种新型抗凝药物。随着新药上市，在治疗患者时应考虑新的药物副作用，特别是在使用区域麻醉时。美国区域麻醉与疼痛医学学会和欧洲各机构均就抗凝药物的使用和脊柱/区域技术提出了建议。对于新型抗凝药物，在进行椎管内注射之前停药的指南是基于药代动力学，包括每种药物的半衰期。虽然每种临床情况都需要个体化方法，但一般指南可以作为起点，帮助进行麻醉计划，并在这个不断发展的领域中提高患者安全性。
