Use of neuraxial anesthesia with selective factor Xa inhibitors.
It has become increasingly well documented that, compared with general anesthesia, neuraxial anesthesia reduces the risk of venous thromboembolism after joint replacement surgery. The concurrent use of anticoagulants with neuraxial anesthesia, however, has raised some safety concerns. Recent large-scale, prospective, randomized experience indicates that the selective factor Xa inhibitor fondaparinux does not increase the risk of epidural hematoma when used in combination with neuraxial anesthesia.
Cannavo
Dominick
D
Department of Anesthesia, Hospital for Joint Diseases, New York University School of Medicine, New York, New York 10003, USA. dcannavomd@aol.com
D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D000925:Anticoagulants / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D065427:Factor Xa Inhibitors; D000077425:Fondaparinux; D006406:Hematoma / Q000209:etiology; D006801:Humans; D019637:Orthopedic Procedures; D011134:Polysaccharides / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D013923:Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D011134:Polysaccharides; D000077425:Fondaparinux