[Lumbar regional analgesia in patients during antithrombotic treatment. Procedures used at the Danish anesthesiologic departments illustrated by a questionnaire study]

Ugeskr Laeger. 1991 Jan 28;153(5):346-8.
[Article in Danish]

Abstract

The attitudes of Danish anaesthetists to employment of lumbar epidural analgesia (EA) or spinal analgesia (SA) in patients receiving perioperative antithrombotic therapy was assessed by a questionnaire investigation. EA and SA were absolute or relative contraindications in patients receiving low-dose heparin therapy in 38% and 24% of the departments. The same figures for patients receiving dextran or acetylsalicylic acid therapy were 3-8%. The limiting value for the P-coagulation factors II, VII and X for employing EA and SA varied considerably in the departments questioned. EA and SA were, however, contraindicated in patients receiving regular anticoagulation in the majority of departments. On a national basis, only two confirmed cases of symptom-producing haemorrhage in the spinal canal which could be attributed to thrombosis prophylaxis after SA/EA have been recognized. Both of these developed after regular anticoagulation therapy. The authors do not find any basis for warning against use of EA/SA in patients receiving subcutaneous heparin therapy, dextran or acetyl salicylic acid, unless another predisposition to haemorrhage is present.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthesia, Epidural / methods*
  • Anesthesia, Epidural / statistics & numerical data
  • Anesthesia, Spinal / methods*
  • Anesthesia, Spinal / statistics & numerical data
  • Attitude of Health Personnel
  • Contraindications
  • Denmark
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Male
  • Premedication
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Fibrinolytic Agents