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Regional Anesthesia in Patients on Anticoagulation Therapies—Evidence-Based Recommendations

  • Other Pain (A Kaye and N Vadivelu, Section Editors)
  • Published:
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Abstract

Purpose of Review

Anticoagulant use among patients is prevalent and increasing. It is important for anesthesiologists to be aware of patients on anticoagulants while performing regional anesthesia.

Recent Findings

In recent years, the FDA has approved many new anticoagulants. With new drugs coming to the market, new side effect profiles should be considered when treating patients, especially when using regional anesthesia. Both ASRA and European agencies have laid out recommendations regarding anticoagulant use and neuraxial/regional techniques. Regarding newer anticoagulants, the guidelines for discontinuation prior to neuraxial injection are based on pharmacokinetics, including half-life duration for each drug.

Summary

While each clinical scenario requires an individualized approach, general guidelines can serve as a starting point to help with anesthetic planning and potentially improve patient safety in this evolving field.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA

    Alan David Kaye

  2. Department of Anesthesiology, LSU Health New Orleans, 1542 Tulane Ave, New Orleans, LA, 70112, USA

    Andrew J. Brunk

  3. Medical University of South Carolina, Charleston, SC, 29425, USA

    Aaron J. Kaye

  4. Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 701123, USA

    Aaron J. Kaye

  5. Department of Anesthesiology, LSU Health Sciences Center, 1901 Perdido St., New Orleans, LA, 70112, USA

    Jordan S. Renschler

  6. Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Brendon M. Hart, Shilpa Patil, Elyse M. Cornett & Charles J. Fox

  7. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Prathima Anandi

Authors
  1. Alan David Kaye
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  2. Andrew J. Brunk
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Corresponding author

Correspondence to Elyse M. Cornett.

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Conflict of Interest

Andrew J. Brunk, Aaron J. Kaye, Jordan S Renschler, Brendon M. Hart, Prathima Anandi, Shilpa Patil, Elyse M. Cornett, and Charles J. Fox declare no conflict of interest. Alan D. Kaye discloses that he is on the Speakers Bureau for Depomed, Inc. and Merck.

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Kaye, A.D., Brunk, A.J., Kaye, A.J. et al. Regional Anesthesia in Patients on Anticoagulation Therapies—Evidence-Based Recommendations. Curr Pain Headache Rep 23, 67 (2019). https://doi.org/10.1007/s11916-019-0805-x

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