[Lumbar regional analgesia in patients during antithrombotic treatment. Procedures used at the Danish anesthesiologic departments illustrated by a questionnaire study].
The attitudes of Danish anaesthetists to employment of lumbar epidural analgesia (EA) or spinal analgesia (SA) in patients receiving perioperative antithrombotic therapy was assessed by a questionnaire investigation. EA and SA were absolute or relative contraindications in patients receiving low-dose heparin therapy in 38% and 24% of the departments. The same figures for patients receiving dextran or acetylsalicylic acid therapy were 3-8%. The limiting value for the P-coagulation factors II, VII and X for employing EA and SA varied considerably in the departments questioned. EA and SA were, however, contraindicated in patients receiving regular anticoagulation in the majority of departments. On a national basis, only two confirmed cases of symptom-producing haemorrhage in the spinal canal which could be attributed to thrombosis prophylaxis after SA/EA have been recognized. Both of these developed after regular anticoagulation therapy. The authors do not find any basis for warning against use of EA/SA in patients receiving subcutaneous heparin therapy, dextran or acetyl salicylic acid, unless another predisposition to haemorrhage is present.
Jørgensen
L N
LN
Centralsygehuset i Hillerød, anaestesiologisk afdeling.
Rasmussen
L S
LS
Wille-Jørgensen
P A
PA
Wiberg-Jørgensen
F
F
D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods* / Q000706:statistics & numerical data; D000775:Anesthesia, Spinal / Q000379:methods* / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D000075202:Contraindications; D003718:Denmark; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D011292:Premedication; D012307:Risk Factors; D011795:Surveys and Questionnaires
D005343:Fibrinolytic Agents