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Anticoagulants and neuro-axis blockades

BACKGROUND AND OBJECTIVES: The use of anticoagulants for thromboprophylaxis has increased the incidence of spinal blockades hematomas. This review aimed at checking the incidence of spinal hematomas and its correlation with anticoagulant drugs. CONTENTS: Some clinical and pharmacological considerations are made about thromboprophylactic drugs (cumarinics, aspirin and heparin). Risk factors are highlighted, especially those related to patients developing epidural hematomas due to the simultaneous use of low molecular weight heparin and epidural anesthesia. CONCLUSIONS: There is an important correlation between epidural hematomas and hemorrhagic disorders, especially in patients under anticoagulant therapy. The awareness of the increased risk associated to epidural and spinal anesthesia, as well as the continuous surveillance and education are fundamental to prevent future cases.

ANESTHETIC TECHNIQUES, Regional: epidural, spinal block; ANTICOAGULANTS; COMPLICATIONS: epidural hematoma


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