Thromboprophylaxis and regional anesthesia

Abstract

Introduction:Thromboprophylaxis and neuroaxial techniques for analgesic and anesthetic purposes are a very common binomial of modern anesthesiology, as well as the use of anticoagulants and platelet antiaggregants for associated diseases.Objective:To present the fundamental aspects to be considered in patients on whom neuroaxial anesthetic techniques will be performed and with whom anticoagulants and/or platelet antiaggregants are used as a prophylaxis of thromboembolic disease.Methods:A search was carried for the bibliography published in Infomed indexed databases, such as Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, in Spanish and English, within a period of four years, from 2016 to 2019. Some aspects are reviewed and presented such as minimum conditions to ensure adequate hemostasis, incidence of spinal cord hemorrhage, safety protocols to avoid hemorrhagic complications, and pharmacological considerations on anticoagulants and platelet antiaggregants in regional techniques.Conclusions:It is necessary to comply with measures that prevent the onset of spinal cord hematoma in patients taking anticoagulants and platelet antiaggregants. It is necessary to take into account each patient’s individual assessment, which is based on the inter- and intra-individual variability that makes it possible to make the best decision in each case.Keywords: thromboprophylaxis; anticoagulation; platelet antiaggregation; neuroaxial anesthesia.