title: Ultrasound-guided peripheral nerve blocks in anticoagulated patients - case series.
abstract: OBJECTIVE
  The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Moreover, peripheral blocks vary in depth, spreadability, and possibility of local compression. However, few societies take it into account when drawing up its recommendations, establishing a single recommendation for performing peripheral blocks, regardless of the route used. The objective of this series is to expand the discussion on peripheral nerve block in anticoagulated patients.
  
  
  METHODS
  This series reports 9 cases of superficial peripheral nerve blocks guided by ultrasound in patients with primary or secondary dyscrasias. All blocks were performed by experienced anesthesiologists in the management of ultrasound, and there was no bruising or neurological injuries in the cases.
  
  
  CONCLUSIONS
  This case series support the discussion on conducting surface peripheral nerve blocks and easy local knowledge as the axillary, interscalene, femoral, saphenous or popliteal in anticoagulated patients, on dual antiaggregation therapy and/or with other coagulation disorders, provided that guided by ultrasound and performed by an anesthesiologist with extensive experience in guided nerve blocks. However, larger series should be performed to prove the safety of the technique for these patients.
authors.affiliation: Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil.
authors.forename: Luis Eduardo Silveira
authors.initials: LE
authors.lastname: Martins
authors.affiliation: Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil; Sociedade Brasileira de Anestesiologia, São Paulo, SP, Brazil. Electronic address: leohcferraro@yahoo.com.br.
authors.forename: Leonardo Henrique Cunha
authors.initials: LH
authors.lastname: Ferraro
authors.affiliation: Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil; Sociedade Brasileira de Anestesiologia, São Paulo, SP, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Takeda
authors.affiliation: Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil; Sociedade Brasileira de Anestesiologia, São Paulo, SP, Brazil.
authors.forename: Masashi
authors.initials: M
authors.lastname: Munechika
authors.affiliation: Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil; Sociedade Brasileira de Anestesiologia, São Paulo, SP, Brazil.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Tardelli
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D065527:Brachial Plexus Block / Q000379:methods; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D012584:Sciatic Nerve; D013514:Surgical Procedures, Operative / Q000379:methods*; D018084:Ultrasonography, Interventional
chemical_list: D000925:Anticoagulants
keywords: Bloqueio nervo periférico; Coagulation; Coagulação; Peripheral nerve block; Ultrasound; Ultrassom