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antiplatelets anaesthesia

Gennaro Scibelli, Lucia Maio, Gennaro Savoia
BACKGROUND: The use of anticoagulant agents represents a serious limitation of regional anesthesia, due to the risk of spinal hematoma. Examining all the principles currently available, it has been possible to notice that published guidelines are very often incomplete or also differ significantly on the rules to be followed relating to a specific drug. METHODS: We have carried out a comparison between the guidelines of major scientific societies in order to take a practical and simple user guide which operators can consult...
December 16, 2016: Minerva Anestesiologica
N S Abyshov, A G Abdullaev, E D Zakirdzhaev, R A Guliev, M B Akhmedov, G T Tagizade, G M Zeinalova, L D Mamedova
AIM: to evaluate the results of combined treatment of thromboangiitis obliterans with severe lower limb ischemia using prolonged epidural anaesthesia and autohemotherapy with ozone. MATERIAL AND METHODS: It was analyzed treatment of 125 patients with thromboangiitis obliterans and severe lower limb ischemia. Patients were divided into 2 groups. Control group consisted of 60 patients who underwent conventional perioperative therapy with anticoagulants, antiplatelet agents, dextrans, metabolic drugs, glucocorticoids, angioprotectors, narcotic and non-narcotic analgesics...
2016: Khirurgiia
Hervé Hourlier, Peter Fennema
BACKGROUND: The effect of tranexamic acid has not been examined in patients who are regular users of antithrombotics before undergoing total knee arthroplasty. The aim of this study was to determine the impact of tranexamic acid on bleeding and the risk of transfusion and thrombosis in patients taking an antithrombotic treatment before primary unilateral total knee arthroplasty. MATERIAL AND METHODS: A prospective observational study was conducted in a series of 385 consecutive primary total knee arthroplasties performed with and without the administration of tranexamic acid...
October 4, 2016: Blood Transfusion, Trasfusione del Sangue
Guillaume Bonnet, Erwan Salaun, Mathieu Pankert, Thomas Cuisset, Jean-Louis Bonnet
BACKGROUND: Left atrial appendage (LAA) closure using the WATCHMAN™ device (WM) may be considered in patients with non-valvular atrial fibrillation (AF) and a high-risk of stroke who are ineligible for long-term oral anticoagulation (OAC). AIM: To report our single-centre preliminary experience, focusing on feasibility, safety and short-term efficacy of this procedure. METHODS: Patients implanted from December 2013 to February 2014 were included...
December 2016: Archives of Cardiovascular Diseases
Marion Vidal, Antoine Strzelecki, Mireille Houadec, Isabelle Ranz Krikken, Antoine Danielli, Edmundo Pereira de Souza Neto
Subarachnoid haematoma after spinal anaesthesia is known to be very rare. In the majority of these cases, spinal anaesthesia was difficult to perform and/or unsuccessful; other risk factors included antiplatelet or anticoagulation therapy, and direct spinal cord trauma. We report a case of subarachnoid haematoma after spinal anaesthesia in a young patient without risk factors.
September 2016: Brazilian Journal of Anesthesiology
Marion Vidal, Antoine Strzelecki, Mireille Houadec, Isabelle Ranz Krikken, Antoine Danielli, Edmundo Pereira de Souza Neto
Subarachnoid haematoma after spinal anaesthesia is known to be very rare. In the majority of these cases, spinal anaesthesia was difficult to perform and/or unsuccessful; other risk factors included antiplatelet or anticoagulation therapy, and direct spinal cord trauma. We report a case of subarachnoid haematoma after spinal anaesthesia in a young patient without risk factors.
September 2016: Revista Brasileira de Anestesiologia
I Phang, R Sivakumaran, M C Papadopoulos
INTRODUCTION: Neurosurgical trainees should achieve competency in chronic subdural haematoma (CSDH) drainage at an early stage in training. The effect of surgeon seniority on recurrence following surgical drainage of CSDH was examined. METHODS: All CSDH cases performed at St George's Hospital in London between March 2009 and March 2012 were analysed. Recurrence was defined as clinical deterioration with computed tomography evidence of CSDH requiring reoperation within six months...
November 2015: Annals of the Royal College of Surgeons of England
R S Vela Vásquez, R Peláez Romero
The safety of aspirin therapy in neuraxial anaesthesia has been historically questioned, and the current recommendations are still heterogeneous. A comprehensive review of clinical evidence and a comparative analysis of European and American guidelines were performed. Low-dose aspirin produces a selective, complete and irreversible cyclooxygenase-1 blockade, and higher doses do not increase the antiplatelet effect. Additional cyclooxygenase-2 blockade by high-dose aspirin might decrease the antithrombotic efficacy by inhibiting endothelial prostacyclin synthesis...
November 2015: British Journal of Anaesthesia
Samer Narouze, Honorio T Benzon, David A Provenzano, Asokumar Buvanendran, José De Andres, Timothy R Deer, Richard Rauck, Marc A Huntoon
Interventional spine and pain procedures cover a far broader spectrum than those for regional anesthesia, reflecting diverse targets and goals. When surveyed, interventional pain and spine physicians attending the American Society of Regional Anesthesia and Pain Medicine (ASRA) 11th Annual Pain Medicine Meeting exhorted that existing ASRA guidelines for regional anesthesia in patients on antiplatelet and anticoagulant medications were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors necessitated separate guidelines for pain and spine procedures...
May 2015: Regional Anesthesia and Pain Medicine
E Vázquez-Alonso, N Fábregas, P Rama-Maceiras, I Ingelmo Ingelmo, R Valero Castell, L Valencia Sola, F Iturri Clavero
OBJECTIVES: To determine the protocols used by Spanish anaesthesiologists for thromboprophylaxis and anticoagulant or antiplatelet drugs management in neurosurgical or neurocritical care patients. MATERIAL AND METHODS: An online survey with 22 questions, with one or multiple options, launched by the Neuroscience Subcommittee of the Spanish Anaesthesia Society and available between June and October 2012. RESULTS: Of the 73 hospitals included in the National Hospitals Catalogue, a valid response to the online questionnaire was received by 41 anaesthesiologists from 37 sites (response rate 50...
December 2015: Revista Española de Anestesiología y Reanimación
Bala D Bande, Saroj B Bande, Suchitra Mohite
Hypercoagulable disorders are now diagnosed more frequently than before. These patients are, usually, managed with multiple anticoagulant and antiplatelet medications. Left unmonitored and unevaluated, there can be disastrous haemorrhagic or thrombotic complications. Appropriate perioperative and anaesthetic management of these patients will invite an aetiological diagnosis, severity analysis and the on-going treatment review. Different assays, thromboelastography and molecular cytogenetics have helped to diagnose these conditions precisely and thus guide the long-term management...
September 2014: Indian Journal of Anaesthesia
Hiroshi Iwabuchi, Yutaka Imai, Soichiro Asanami, Masayori Shirakawa, Gen-yuki Yamane, Hideki Ogiuchi, Kenji Kurashina, Masaru Miyata, Hiroyuki Nakao, Hirohisa Imai
OBJECTIVES: We investigated incidence and risk factors for postextraction bleeding in patients receiving warfarin and those not receiving anticoagulation therapy. DESIGN: Cross-sectional, multicentre, observational study. SETTING: 26 hospitals where an oral surgeon is available. PARTICIPANTS: Data on 2817 teeth (from 496 patients receiving warfarin, 2321 patients not receiving warfarin; mean age (SD): 62.2 (17.6)) extracted between 1 November 2008 and 31 March 2010, were collected...
2014: BMJ Open
Annouk Perret Morisoli, Fabrizio Gronchi, Enrico Ferrari, Catherine Blanc, Philippe Frascarolo, Anne Angelillo-Scherrer, Carlo Marcucci
BACKGROUND: Multiple electrode aggregometry (MEA) is a point-of-care test evaluating platelet function and the efficacy of platelet inhibitors. In MEA, electrical impedance of whole blood is measured after addition of a platelet activator. Reduced impedance implies platelet dysfunction or the presence of platelet inhibitors. MEA plays an increasingly important role in the management of perioperative platelet dysfunction. In vitro, midazolam, propofol, lidocaine and magnesium have known antiplatelet effects and these may interfere with MEA interpretation...
September 2014: European Journal of Anaesthesiology
Süleyman Sürer, Faruk Toktas, Derih Ay, Cuneyt Eris, Senol Yavuz, Tamer Turk, Ahmet Hakan Vural, Mehmet Tugrul Goncu, Nihal Yasar Gul, Ulviye Yalcınkaya
OBJECTIVES: In the present study, we aimed to deterimine the dose-related effects of ticagrelor, the first reversible inhibitor of the P2Y12 receptor, found in smooth muscle cells as well as platelets, during neointimal hyperplasia in a rabbit carotid anastomosis model. METHODS: This study was an experimental, prospective, randomized controlled study including 20 New Zealand white female rabbits (6-months old; weighing 2300 ± 300 g). Under general anaesthesia, the rabbits underwent transection of the right carotid artery and subsequent anastomosis of both ends...
August 2014: Interactive Cardiovascular and Thoracic Surgery
Roberta Rossini, Giuseppe Musumeci, Luigi Oltrona Visconti, Ezio Bramucci, Battistina Castiglioni, Stefano De Servi, Corrado Lettieri, Maddalena Lettino, Emanuela Piccaluga, Stefano Savonitto, Daniela Trabattoni, Davide Capodanno, Francesca Buffoli, Alessandro Parolari, Gianlorenzo Dionigi, Luigi Boni, Federico Biglioli, Luigi Valdatta, Andrea Droghetti, Antonio Bozzani, Carlo Setacci, Paolo Ravelli, Claudio Crescini, Giovanni Staurenghi, Pietro Scarone, Luca Francetti, Fabio D'Angelo, Franco Gadda, Andrea Comel, Luca Salvi, Luca Lorini, Massimo Antonelli, Francesco Bovenzi, Alberto Cremonesi, Dominick J Angiolillo, Giulio Guagliumi
Optimal perioperative antiplatelet therapy in patients with coronary stents undergoing surgery still remains poorly defined and a matter of debate among cardiologists, surgeons and anaesthesiologists. Surgery represents one of the most common reasons for premature antiplatelet therapy discontinuation, which is associated with a significant increase in mortality and major adverse cardiac events, in particular stent thrombosis. Clinical practice guidelines provide little support with regard to managing antiplatelet therapy in the perioperative phase in the case of patients with non-deferrable surgical interventions and/or high haemorrhagic risk...
May 2014: EuroIntervention
H T Benzon, M J Avram, D Green, R O Bonow
The new oral anticoagulants are approved for a variety of clinical syndromes, including the prevention of stroke in atrial fibrillation, acute coronary syndromes, treatment of venous thromboembolism (VTE), and prevention of venous thrombosis after total joint surgery or hip fracture. Published guidelines have differing recommendations on the safe interval between discontinuation of the anticoagulant and performance of neuraxial procedures and between the interventional procedure and redosing of the drug. While two to three half-life intervals might be acceptable in patients who are at high risk for VTE or stroke, an interval of four to six half-lives between discontinuation of the drug and neuraxial injections is probably safer in most patients at low risk of thrombosis...
December 2013: British Journal of Anaesthesia
F Reguant, E Martínez, B Gil, J C Prieto, L del Milagro Jiménez, A Arnau, J Bosch
OBJECTIVES: To assess the incidence of postoperative complications, blood transfusions and survival at one month, in the old patients operated for hip fracture undergoing chronic treatment with antiplatelet drugs. MATERIAL AND METHODS: Two hundred twenty three patients operated for hip fracture were studied retrospectively, separated into 3 groups: patients who received acetylsalicylic acid (group I), patients who were given 100mg/day of acetylsalicylic acid or 300mg/day of triflusal (group II) and patients receiving>100mg/day of acetylsalicylic acid, or>300mg/day of triflusal or thienopyridines (group III)...
November 2013: Revista Española de Anestesiología y Reanimación
M Dall'olio, F Calbucci, A Fioravanti, C Bortolotti, L Cirillo, C Princiotta, M Leonardi
Balt (Montmorency, France) recently manufactured the Leo+Baby dedicated intracranial stent for arteries with a calibre between 1.5 and 3.10 mm. We describe a patient with a partially thrombosed giant sacciform aneurysm of the anterior communicating artery treated without success by surgery and coil embolization subsequently occluded by placement of a Leo+Baby stent (Balt, Montmorency, France). A 56-year-old man presented with a giant aneurysm in the anterior communicating artery region. Following successive surgical intervention and embolization procedures the patient was referred to us with a revascularized aneurysm measuring 15×9×8 cm...
June 2013: Neuroradiology Journal
M A Ruiz-Iban, J Díaz-Heredia, M E Elías-Martín, L A Martos-Rodríguez, I Cebreiro-Martínez del Val, F J Pascual-Martín-Gamero
Venous thromboembolism events (VTE) prophylaxis after elective hip or knee replacement surgery is a subject of controversy. Three sets of guidelines (NICE, ACCP and AAOS) on this topic have recently been updated. The guidelines have points in common: prophylaxis is necessary, it is recommended to combine mechanical and pharmacological prophylaxis in patients who have suffered a previous VTE, isolated mechanical measures and low molecular weight heparins are effective, the new oral anticoagulants and fondaparinux are effective drugs...
July 2012: Revista Española de Cirugía Ortopédica y Traumatología
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