Bleeding risk and interventional pain management.
OBJECTIVE
Interventional pain management is an emerging specialty that uses procedures to diagnose and treat chronic pain. Most of these procedures are performed percutaneously and carry a risk of bleeding. Patients undergoing these treatments may be receiving exogenous anticoagulants. The pain practitioner faces a dilemma in performing an elective procedure on a patient with a bleeding risk.


RESULTS
A literature review about coagulation physiology and pathophysiology, anticoagulants, and bleeding complications in interventional pain would be useful to a busy pain physician. This review aims to meet this knowledge goal.


CONCLUSIONS
Knowledge about normal and impaired hemostasis, coupled with a bleeding risk tool, enables practitioners to make informed decisions when offering interventional pain care to their patients.
Shah
Rinoo V
RV
Department of Anesthesiology, Guthrie Clinic-Big Flats, Horseheads, New York 14845, USA. rinoo_shah@yahoo.com
Kaye
Alan D
AD
D015360:Analgesia, Epidural / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects*; D001777:Blood Coagulation / Q000187:drug effects*; D006470:Hemorrhage / Q000517:prevention & control*; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects; D010146:Pain / Q000188:drug therapy*; D012307:Risk Factors
D000925:Anticoagulants