Abstract:
:The use of direct oral anticoagulants including apixaban, rivaroxaban, and dabigatran, which are approved for several therapeutic indications, can simplify perioperative and postoperative management of anticoagulation. Utilization of regional neuraxial anesthesia in patients receiving anticoagulants carries a relatively small risk of hematoma, the serious complications of which must be acknowledged. Given the extensive use of regional anesthesia in surgery and the increasing number of patients receiving direct oral anticoagulants, it is crucial to understand the current clinical data on the risk of hemorrhagic complications in this setting, particularly for anesthesiologists. We discuss current data, guideline recommendations, and best practice advice on effective management of the direct oral anticoagulants and regional anesthesia, including in specific clinical situations, such as patients undergoing major orthopedic surgery at high risk of a thromboembolic event, or patients with renal impairment at an increased risk of bleeding.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Cappelleri G,Fanelli Adoi
10.1016/j.jclinane.2016.02.028subject
Has Abstractpub_date
2016-08-01 00:00:00pages
224-35eissn
0952-8180issn
1873-4529pii
S0952-8180(16)30020-4journal_volume
32pub_type
杂志文章,评审abstract:STUDY OBJECTIVE:To examine postoperative sore throat resulting from tracheal intubation stylet removal. DESIGN:Prospective cohort study. SETTING:Operating rooms and hospital ward. PATIENTS:A total of 50 American Society of Anesthesiologists physical status 1 and 2 patients who underwent elective abdominal and/or ort...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.12.024
更新日期:2016-09-01 00:00:00
abstract::Vagus nerve stimulation (VNS) for medically refractory seizures has been an approved therapy by the Food and Drug Administration since 1997, with additional approval as an adjunct therapy for major depression granted in 2005. Potential applications for VNS therapy in obesity, neuropsychiatric disorders, and chronic pa...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2009.10.002
更新日期:2010-05-01 00:00:00
abstract::The local anesthetic systemic toxicity can be due to increased blood lignocaine levels or due to increased sensitivity to lignocaine. Several cases of lignocaine-induced central nervous system toxicity have been noted, but none have reported only loss of consciousness without any seizure-like activity. Intravenous lip...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.08.039
更新日期:2017-02-01 00:00:00
abstract:STUDY OBJECTIVES:To test the effect of stellate ganglion block on tympanic membrane temperatures. DESIGN:Prospective, observational study. SETTING:Department of Anesthesia, Yamanashi Medical University, Yamanashi, Japan. SUBJECTS:7 healthy male volunteers. INTERVENTIONS:Stellate ganglion block, 6 ml of 1% mepivacai...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(98)00092-0
更新日期:1998-12-01 00:00:00
abstract::Pneumothorax may be a medical emergency. Iatrogenic pneumothorax is more common than all other forms of spontaneous pneumothorax, and surgical procedures involving the breast are a frequent setting for this. A 32-year-old, 60 kg, woman without any significant medical history underwent a bilateral breast augmentation a...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(95)00059-q
更新日期:1995-08-01 00:00:00
abstract:STUDY OBJECTIVE:To compare a multiport, firm-tipped, close-ended, epidural catheter (Portex catheter) with a uniport, open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients. STUDY DESIGN:Prospective data collection for intradepartmental quality assurance. SETTING:Obstetric unit in a ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00116-1
更新日期:2000-03-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effects of intravenous (IV) versus oral clonidine on alterations of heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), and plasma-catecholamines due to endotracheal intubation. DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:University hospital su...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/S0952-8180(97)00239-0
更新日期:1997-03-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the clinical impact of paravertebral blocks (PVBs) on the immediate outcome of patients undergoing radical prostatectomy. DESIGN:Retrospective review. SETTING:Urology ward of a university medical center. MEASUREMENTS:Records of 100 consecutive patients who underwent a radical prostatectomy ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.12.003
更新日期:2007-06-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether betamethasone decreases the incidence of postoperative nausea/vomiting (PONV) and reduces postoperative pain following partial mastectomy. DESIGN:Prospective randomized, double-blinded study. SETTING:Operating room and Postanesthesia Care Unit of a university hospital. PATIENTS...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2014.02.006
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:To study the development and implementation of a hospital-wide protocol regarding preoperative beta-blocker therapy. DESIGN:Prospective, observational clinical study. SETTING:Preoperative test center at a university hospital. PATIENTS:1,000 consecutive patients presenting for a preoperative visit and...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.06.007
更新日期:2008-12-01 00:00:00
abstract:STUDY OBJECTIVE:To quantify global coagulation and establish normal ranges for the celite-activated thrombelastograph (TEG) in healthy pediatric patients. DESIGN:Prospective observational study. SETTING:Operating suite of a university-based hospital. PATIENTS:110 healthy pediatric patients in four age groups and 25 ...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(00)00238-5
更新日期:2001-02-01 00:00:00
abstract::Opioids decrease the sympathetic and somatic responses to noxious stimulation and can be given in high doses without negative inotropic effects, even in patients with impaired cardiac function. With currently available opioids, precise titration of dose to effect is difficult, and high doses result in drug accumulatio...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(96)00179-1
更新日期:1996-12-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the opioid-sparing and analgesic effect of diclofenac sodium in ambulatory nonimmersion extracorporeal shock wave lithotripsy (ESWL). DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:Large referral hospital. PATIENTS:Twenty-seven ASA physical status I and II patients wit...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(93)90142-2
更新日期:1993-03-01 00:00:00
abstract::A case of unusual triple knotting of a central venous catheter inserted through the left basilic vein is reported. The catheter with intact triple knots could be withdrawn without an invasive maneuver. A possible cause of triple knotting was discussed in regard to the anatomic configuration of the central veins. This ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(89)90045-7
更新日期:1989-01-01 00:00:00
abstract::In conclusion, providing anesthesia for a small child undergoing craniofacial reconstructive surgery is an enormous challenge. Even with the most experienced pediatric anesthesiologist and pediatric surgeons, problems can develop suddenly and lead, as they did in this case, to serious morbidity and even death. It is d...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(97)00162-1
更新日期:1997-11-01 00:00:00
abstract::Horner's syndrome is a complication of epidural analgesia and anesthesia, encountered more commonly in pregnant women than in other patients. Previous reports described the appearance of Horner's syndrome following epidural injection of concentrated local anesthetic solutions. We report unilateral Horner's syndrome oc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(03)00017-5
更新日期:2003-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the profile of molecular hemostatic markers in patients receiving either spinal or balanced general anesthesia for total hip arthroplasty. DESIGN:Open, randomized, observational study. SETTING:Orthopedic unit and central laboratory of a university hospital. PATIENTS:26 consenting ASA phys...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(03)00082-5
更新日期:2003-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess bispectral index (BIS) monitoring on decision making during cardiac surgery with cardiopulmonary bypass (CPB) by measuring the number of preset standardized comments with and without knowing the BIS value and by classifying the interventions following the BIS data. DESIGN:Prospective, randomi...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2004.12.018
更新日期:2005-11-01 00:00:00
abstract:STUDY OBJECTIVES:To investigate the hypothesis that the combination of ondansetron and droperidol would be more effective than droperidol alone in reducing nausea and vomiting. DESIGN:Randomized, doubleblind study. SETTING:Magee-Womens Hospital, Pittsburgh, Pennsylvania. PATIENTS:160 healthy, ASA physical status I a...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(97)00188-8
更新日期:1998-02-01 00:00:00
abstract::Acute respiratory failure in the perioperative period represents a frequent challenge to the anesthesiologist. The differential diagnosis is extensive and includes alterations on the pulmonary parenchyma, pulmonary vessels, airway, and cardiac system. Occasionally, two or more pathophysiological process superimpose. W...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(01)00336-1
更新日期:2001-12-01 00:00:00
abstract:STUDY OBJECTIVE:Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of the neuromuscular junction that manifests with muscle weakness, autonomic and bulbar dysfunction, and increased sensitivity to neuromuscular blocking drugs. The objective of this study is to review perioperative outcomes on a series o...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.09.009
更新日期:2014-12-01 00:00:00
abstract::Subcutaneous targeted neuromodulation has been used successfully in chronic neuropathic pain. A 26 year-old patient with severe postthoracotomy pain and ipsilateral "wing scapula" due to intraoperative injury of the long thoracic nerve, is reported. Application of targeted neuromodulation resulted in immediate pain re...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.10.018
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:Anesthesiologists are often involved in the early management and resuscitation of patients who have sustained cervical spine injuries (CSIs). The most crucial step in managing a patient with suspected CSI is the prevention of further insult to the cervical spine (C-spine). In this review, important factors rela...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2005.04.003
更新日期:2005-12-01 00:00:00
abstract::This study aimed to review research on the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on β-endorphin. NSAIDs are commonly used as anti-inflammatory and analgesic drugs. They are well known for inducing peripheral analgesia by inhibiting cyclooxygenase (COX). However, an increasing number of studies have ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2016.12.016
更新日期:2017-02-01 00:00:00
abstract:STUDY OBJECTIVES:To assess whether the year of residency in anesthesiology is associated with residents' overall perceptions of the learning environment and to evaluate the association between year of residency and each of the five domains of the Dundee Ready Education Environment Measure (DREEM) survey. DESIGN:Cross-...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.09.017
更新日期:2016-12-01 00:00:00
abstract::During surgical removal of tumors of the skull base or cerebellopontine angle with brainstem compression, the vagus nerve is at a high risk for injury that can result in permanent or transient swallowing and speech dysfunction. Intramuscular recording of cricothyroid muscle can be used for vagal nerve mapping during i...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.01.002
更新日期:2015-05-01 00:00:00
abstract::Myotonic dystrophy (DM), though rare, can significantly complicate anesthesia due to muscular and extra-muscular involvement. When this condition is compounded by a pheochromocytoma, anesthetizing such patients becomes extra challenging. We present a case report of a 61-year-old lady with congenital DM, with the whole...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.03.035
更新日期:2016-11-01 00:00:00
abstract::A 53-year-old healthy man underwent elective laparoscopic, extraperitoneal, right-sided herniorrhaphy. Postoperatively, he complained of chest pain on inspiration. Chest x-ray and computed tomographic scan revealed a pneumomediastinum and a right-sided pneumothorax. Previous case reports and possible etiologies are re...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2004.05.009
更新日期:2005-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of thoracic epidural analgesia (TEA) in scoliosis surgery. DESIGN:Descriptive clinical study. SETTING:University hospital. PATIENTS:15 ASA physical status I, II, and III patients undergoing thoracolumbar scoliosis correction. INTERVENTIONS:TEA was performed at three to 5 cm ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.10.011
更新日期:2010-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the safety and efficacy of monitored anesthesia care (MAC) in patients who undergo a novel treatment for hepatocellular cancer in which procedure-related hemodynamic instability is problematic. DESIGN:Nonrandomized open study. SETTING:University cancer center operating room. PATIENTS:Nine...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00031-7
更新日期:1997-05-01 00:00:00