1. Bleeding complications following peripheral regional anaesthesia in patients treated with anticoagulants or antiplatelet agents: A systematic review
- Author
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E. Marret, H. Bouaziz, Pierre Gillois, Pierre Albaladejo, F. Joubert, G. Iohom, Bioinformatics and Computational Biology Unit, Faculty of Natural and Agricultural Sciences-University of Pretoria [South Africa], Service d'Anesthésie et Réanimation [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
- Subjects
medicine.medical_specialty ,Blood transfusion ,medicine.drug_class ,medicine.medical_treatment ,[SCCO.COMP]Cognitive science/Computer science ,Hemorrhage ,Punctures ,Critical Care and Intensive Care Medicine ,Medical Records ,Catheterization ,03 medical and health sciences ,0302 clinical medicine ,[STAT.ML]Statistics [stat]/Machine Learning [stat.ML] ,Anesthesia, Conduction ,[MATH.MATH-ST]Mathematics [math]/Statistics [math.ST] ,medicine ,Humans ,General anaesthesia ,030212 general & internal medicine ,Embolization ,ComputingMilieux_MISCELLANEOUS ,Hematoma ,[STAT.AP]Statistics [stat]/Applications [stat.AP] ,Lumbar plexus ,business.industry ,Incidence ,Anticoagulant ,Anticoagulants ,030208 emergency & critical care medicine ,Nerve Block ,General Medicine ,[SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM] ,3. Good health ,Surgery ,Catheter ,Observational Studies as Topic ,Anesthesiology and Pain Medicine ,Nerve block ,Platelet aggregation inhibitor ,business ,[STAT.ME]Statistics [stat]/Methodology [stat.ME] ,Platelet Aggregation Inhibitors - Abstract
Background Patients on either antiplatelet or anticoagulant therapy may need procedures performed under peripheral nerve blocks in preference to general anaesthesia techniques. The risk of bleeding associated with peripheral nerve blocks under these circumstances remains unknown. This systematic review evaluates the incidence of bleeding complications following peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication. Method All English, French and Spanish publications on peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication, from 1978 to 2018 from various sources including Pubmed, were reviewed. Publications on neuraxial anaesthesia (spinal or epidural) and eye blocks were excluded. Results Twenty-four articles were selected, including six observational studies and 18 case reports. Patients received antiplatelet agents only, in 4 studies, anticoagulants only in 14 studies, and both in 6 studies. In the observational studies, 80 bleeding complications (haematoma or minor bleeding at the puncture site) were identified following 9738 peripheral nerve blocks. Amongst case reports, 15 bleeding complications were noted following 50 peripheral nerve blocks. Bleeding complications were reported mostly with lumbar plexus blocks (1 requirement for blood transfusion, 1 catheter embolization, 1 surgical exploration and 1 death). The overall estimate of the incidence of bleeding complications was 0.82% (0.64%–1.0%). Conclusion This systematic review found that bleeding complications following peripheral nerve blocks were rare in patients receiving antiplatelet and/or anticoagulant medication.
- Published
- 2018