The perioperative use of oral anticoagulants during surgical procedures for carpal tunnel syndrome. A preliminary study.
BACKGROUND
To evaluate the feasibility of designing a randomized controlled study whether open carpal tunnel release (OCTR) surgery can be performed safely under systemic anticoagulant therapy using acetylsalicylacid (ASA) or acenocoumarol (ACM), this preliminary, observational study was performed.


METHODS
Prospectively, during 1 year, data were collected from all patients who underwent conventional OCTR at the neurosurgical department of the Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. Patients continued anticoagulant treatment perioperatively.


RESULTS
A total of 364 patients were operated on, of whom 45 continued ASA and seven ACM treatment. Only one patient using ASA complained of a postoperative subcutaneous hemorrhage. In the control group without anticoagulants, none of the patients had a bleeding postoperatively.


CONCLUSIONS
Continuation of anticoagulant treatment is safe for OCTR. The adverse effects of stopping treatment for surgery can be severe. As a result of this study, we have changed our surgery protocol for OCTR and continue anticoagulant treatment perioperatively.
Nandoe Tewarie
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RD
Department of Neurosurgery, Radboud University Nijmegen Medical Center, Reinier Postlaan 4, 6500HB, Nijmegen, The Netherlands. R.D.S.Nandoe@nch.umcn.nl
Bartels
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RH
D000074:Acenocoumarol / Q000627:therapeutic use; D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D002985:Clinical Protocols; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D010865:Pilot Projects; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D013923:Thromboembolism / Q000188:drug therapy / Q000517:prevention & control
D000925:Anticoagulants; D000074:Acenocoumarol; D001241:Aspirin