Regional anesthesia
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Regional anesthesia · Nov 1996
Hemostasis-altering drugs and central neural block. A survey of anesthetic practice in Scotland and the United Kingdom.
There is debate regarding the use of central neural block in the presence of hemostasis-altering drugs. This study aims to examine current practice. ⋯ There is general agreement regarding contraindication of central neural block in the presence of full anticoagulation with either heparin or warfarin, but there is less consensus about the use of central neural block in the presence of low-dose subcutaneous heparin. There is some confusion about the role of aspirin and its duration of action.
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialSubarachnoid neostigmine does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
Intraspinal administration of neostigmine has been shown to prevent induction of hypotension in rats by bupivacaine spinal block, and thus to provide greater hemodynamic stability. This study was undertaken to determine whether subarachnoid neostigmine would prevent bupivacaine spinal anesthesia from causing hypotension or bradycardia in patients undergoing abdominal hysterectomy. ⋯ A 75-micrograms subarachnoid neostigmine dose does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
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The use of regional anesthesia in patients receiving anticoagulants is controversial. The purpose of this review is to document the incidence of neurologic complications with insertion and removal of an epidural catheter in patients receiving oral anticoagulants and antiplatelet medication. ⋯ Epidural catheter placement and removal in patients taking oral anticoagulants appears to be safe. Careful monitoring of the patient for evidence of spinal hematoma after epidural catheter removal is recommended.