A Comprehensive Review of Thromboprophylaxis and Its Implications in Regional Anaesthesia | Chapter 12 | Medical Science: Recent Advances and Applications Vol. 7

 

Venous thromboembolism, comprising both Deep Venous Thrombosis and Pulmonary Embolism, is a chronic illness. VTE is an important cause of postoperative morbidity and mortality, especially when patients with co-morbid conditions (like obesity, coronary artery disease, or cancer) are on the rise. This necessitates the use of various thromboprophylaxis measures to prevent the occurrence of fatal VTE. However, the pharmacological thromboprophylaxis carries an inherent risk of bleeding, especially when the area of invasive work involves a potential space with a risk of non-compressible arterial puncture. During neuraxial anaesthesia, such bleeding into a closed space can result in spinal hematoma, which carries various neurological sequelae and requires urgent diagnosis and management.

 

The aim of the study is to review and analyse the relevant literature on the modalities of thromboprophylaxis, their mechanism of action and optimal management of such patients in the perioperative setting. In the perioperative setting, managing a patient on thromboprophylaxis therapy is still challenging, and with the introduction of various newer anticoagulants, management becomes more perplexing. In view of limited randomised trials pertaining to the thromboprophylaxis management in regional anaesthesia settings, a thorough knowledge of the mechanism and duration of action of these anticoagulant drugs, as well as recommended guidelines, is essential for the effective management of such patients.

 

Author(s) Details

Ragi Jain
Department of Anesthesia, Santosh Medical and Dental College and Hospital, Ghaziabad (Uttar Pradesh), India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v7/5736