Hesse T, Holst D, Möllmann M, Wendt M
Klinik und Poliklinik für Anästhesiologie und Intensivmedizin, Ernst-Mortiz-Arndt-Universität Greifswald.
Anaesthesiol Reanim. 1996;21(5):116-21.
Epidural and spinal blocks can lead to iatrogenic bleeding in the spinal canal. Incidence of this severe complication is considered low, but the risk of irreversible neurological defects for the patient requires increased attention by the anaesthetist. The perioperative risk is higher in patients under anticoagulant therapy. The different pharmacodynamics and pharmacokinetics of practically relevant anticoagulants are discussed and recommendations for the performance of centroneuraxis blocks in patients under anticoagulant therapy are given.
硬膜外阻滞和脊髓阻滞可导致椎管内医源性出血。这种严重并发症的发生率被认为较低，但患者出现不可逆神经功能缺损的风险需要麻醉医生给予更多关注。接受抗凝治疗的患者围手术期风险更高。本文讨论了实际应用的抗凝剂不同的药效学和药代动力学，并给出了接受抗凝治疗患者进行中枢神经轴阻滞的建议。
