Stručni rad

New anticoagulants and regional anaesthesia in patients undergoing orthopedic surgery

BRANKO TRIPKOVIĆ ; Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Šalata 6, Zagreb, Croatia
ŠIMUN ŠAKIĆ

Sažetak

Background and Purpose: there are many advantages of regional anaesthesia for orthopedic procedures. In perioperative period orthopedic patients received thromboprophylaxis with low mollecular weight heparins (LMWH) or new anticoagulated drugs. The most popular new drugs for thromboprophylaxis in patients with joint replacement are fondaparinux, rivaroxaban and dabigatran. After introduction of LMWH for thromboprophylaxis serious complications including spinal hematom have been reported. It is very important perform regional anaesthesia in patients receiving anticoagulated drugs according to recommendations. These article reviews the actual recommendations and the current status and management
of these new drugs.

Recent findings: recent studies are outlined that the risk of spinal
hematoma after neuraxial anaesthesia may be higher than estimated. The use of new anticoagulant drugs should take into account the pharmacological profile of each drug to safely perform regional anaesthesia, mainly the time to reach peak plasma level and half-life.

Conclusion: When new anticoagulant drugs are used for thromboprophylaxis in orthopedic surgery, the performance of neuraxial anaesthesia is safe method if is based on the pharmacology of drugs. All methods of regional anaesthesia should be perfomed according to accepted recommendations
regarding the time of block and the time of drug administration.

Ključne riječi

Hrčak ID:

70112

URI

https://hrcak.srce.hr/70112

Datum izdavanja:

1.6.2011.

Posjeta: 1.193 *