Glebov Maxim, Portnoy Yotam, Patapanyan Estela, Drori Elad, Katsin Maksim, Berkenstadt Haim, Orkin Dina
From the Department of Anesthesiology, Sheba Medical Center, Ramat Gan, Israel.
Arrow Program for Medical Research Education, Sheba Medical Center, Ramat Gan, Israel.
A A Pract. 2025 Jan 10;19(1):e01899. doi: 10.1213/XAA.0000000000001899. eCollection 2025 Jan 1.
This case series reviews surgeries involving elderly patients with femoral neck fractures on apixaban who underwent spinal anesthesia (SA) within 72 hours of their last dose. Despite patients being on anticoagulation, no neurological complications occurred, suggesting SA may be practical in cases where the benefits of timely surgery outweigh the potential risks, including apixaban discontinuation for a period of less than the recommended 72 hours with detectable levels of the drug remaining in the plasma. Quantitative apixaban measurements offered useful anticoagulation status insights, though safe thresholds remain undefined.
本病例系列回顾了接受阿哌沙班治疗的老年股骨颈骨折患者在末次给药后72小时内接受脊髓麻醉（SA）的手术情况。尽管患者正在接受抗凝治疗，但未发生神经并发症，这表明在及时手术的益处超过潜在风险的情况下，脊髓麻醉可能是可行的，包括在血浆中仍可检测到药物水平的情况下，在少于推荐的72小时内停用阿哌沙班。阿哌沙班的定量测量提供了有用的抗凝状态信息，尽管安全阈值仍未确定。
