Neuraxial block and low-molecular-weight heparin: Balancing perioperative analgesia and thromboprophylaxis

被引:141
作者
Horlocker, TT [1 ]
Wedel, DJ [1 ]
机构
[1] Mayo Clin & Mayo Fdn, Dept Anesthesiol, Rochester, MN 55905 USA
关键词
D O I
10.1016/S1098-7339(98)90143-2
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The efficacy and safety of low-molecular-weight heparins (LMWH) as postoperative venous thromboembolism prophylaxis has been demonstrated in more than 60 clinical trials, including more than 20,000 patients (1). However, recent reports of spinal hematoma occurring spontaneously and in association with regional anesthesia (2, 3) have generated concern regarding the safety of spinal or epidural anesthesia in patients receiving LMWH. This review will discuss the chronology of events leading to the current situation, as well as examine the possible factors contributing to the increased risk of spinal hematoma in patients receiving LMWH.
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页码:164 / 177
页数:14
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