[Should we give up combining spinal anesthesia and anticoagulants?].
The risk of lumbar haematoma potentially increased by the association of regional anaesthesia and anticoagulant treatment has been widely debated. Few data are available in order to estimate the level of this risk, which is probably very low. However, even if it is now clear that regional anaesthesia is not potent enough to prevent postoperative deep vein thrombosis (DVT), a partial decrease in the DVT rate between 30 and 40% has been observed. Furthermore, no randomized double blind study has established the usefulness of the preoperative injection of heparin. Accordingly, when it is possible, it is best to avoid the preoperative injection and to start heparin treatment postoperatively. This solution is safe and effective.
Samama
C M
CM
Département d'Anesthésie-Réanimation (Pr Coriat), Groupe Hospitalier, Pitié-Salpêtrière, Paris.
D000775:Anesthesia, Spinal; D000925:Anticoagulants / Q000627:therapeutic use*; D003245:Consensus Statements as Topic; D000075202:Contraindications; D006407:Hematoma, Epidural, Cranial / Q000209:etiology; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012306:Risk; D013927:Thrombosis / Q000517:prevention & control
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight