title: Guidelines and alternatives for neuraxial anesthesia and venous thromboembolism prophylaxis in major orthopedic surgery.
abstract: Neuraxial anesthesia during major orthopedic surgery, combined with venous thromboembolism prophylaxis, is generally safe and well tolerated, with potential benefits over general anesthesia. The risk of spinal/epidural hematoma, a rare but very serious complication, can be minimized by careful patient selection and attention to anesthetic technique. This risk is further reduced with the use of peripheral nerve blocks in place of neuraxial anesthesia.
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Hantler
authors.forename: George J
authors.initials: GJ
authors.lastname: Despotis
authors.forename: Raj
authors.initials: R
authors.lastname: Sinha
authors.forename: Jacques E
authors.initials: JE
authors.lastname: Chelly
mesh_terms: D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000379:methods*; D000768:Anesthesia, General; D001241:Aspirin / Q000627:therapeutic use; D065427:Factor Xa Inhibitors; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D019637:Orthopedic Procedures; D020246:Venous Thrombosis / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000494:pharmacology
chemical_list: D065427:Factor Xa Inhibitors; D014812:Vitamin K; D014859:Warfarin; D006493:Heparin; D001241:Aspirin