Linked Life Data

20052816

Source:http://linkedlifedata.com/resource/pubmed/id/20052816

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2010-1-6
pubmed:abstractText
The actual incidence of neurologic dysfunction resulting from hemorrhagic complications associated with neuraxial blockade is unknown. Although the incidence cited in the literature is estimated to be less than 1 in 150,000 epidural and less than 1 in 220,000 spinal anesthetics, recent epidemiologic surveys suggest that the frequency is increasing and may be as high as 1 in 3000 in some patient populations.Overall, the risk of clinically significant bleeding increase with age,associated abnormalities of the spinal cord or vertebral column, the presence of an underlying coagulopathy, difficulty during needle placement,and an indwelling neuraxial catheter during sustained anticoagulation( particularly with standard heparin or low-molecular weight heparin). The need for prompt diagnosis and intervention to optimize neurologic outcome is also consistently reported. In response to these patient safety issues, the American Society of Regional Anesthesia and Pain Medicine (ASRA) convened its Third Consensus Conference on Regional Anesthesia and Anticoagulation. Practice guidelines or recommendations summarize evidence-based reviews. However, the rarity of spinal hematoma defies a prospective randomized study, and there is no current laboratory model. As a result,the ASRA consensus statements represent the collective experience of recognized experts in the field of neuraxial anesthesia and anticoagulation. These are based on case reports, clinical series, pharmacology,hematology, and risk factors for surgical bleeding. An understanding of the complexity of this issue is essential to patient management.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1532-8651
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
35
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
64-101
pubmed:meshHeading
pubmed-meshheading:20052816-Anesthesia, Conduction, pubmed-meshheading:20052816-Anesthesiology, pubmed-meshheading:20052816-Anticoagulants, pubmed-meshheading:20052816-Evidence-Based Medicine, pubmed-meshheading:20052816-Female, pubmed-meshheading:20052816-Fibrinolytic Agents, pubmed-meshheading:20052816-Hematoma, Epidural, Spinal, pubmed-meshheading:20052816-Heparin, pubmed-meshheading:20052816-Humans, pubmed-meshheading:20052816-Male, pubmed-meshheading:20052816-Nerve Block, pubmed-meshheading:20052816-Phytotherapy, pubmed-meshheading:20052816-Plant Preparations, pubmed-meshheading:20052816-Platelet Aggregation Inhibitors, pubmed-meshheading:20052816-Pregnancy, pubmed-meshheading:20052816-Pregnancy Complications, Hematologic, pubmed-meshheading:20052816-Societies, Medical, pubmed-meshheading:20052816-United States, pubmed-meshheading:20052816-Venous Thromboembolism, pubmed-meshheading:20052816-Warfarin
pubmed:articleTitle
Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition).
pubmed:affiliation
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA. horlocker.terese@mayo.edu
pubmed:publicationType
Journal Article, Practice Guideline