Are GUIDELINES enough for perioperative patients taking anticoagulants and thrombolytic agents

What is it about?

Identifing the most updated guidelines (2015) for patients taking anticoagulant medications and scheduled for surgery. As prospective randomized controlled trials examining this issue has proven difficult; the only parameters to base perioperative decisions related to regional anesthesia/acute pain medicine depends upon case reports/case series, expert opinion, pharmacology profiles of respective agents, hematologists, and clinician experience. However, can safe regional pain management interventions always be secured in all patient populations such as: the elderly, those with significant comorbidities (ex. renal dysfunction, cardiac disease), pregnant patients, trauma surgery, low risk surgical procedures, etc.

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Why is it important?

To provide safe and effective multimodal analgesia; regional anesthesia is a vital part of such perioperative pain medicine interventions. However, risk-to-benefit decisions must be made for every patient taking coagulation altering medications when considering neuraxial and deep peripheral nerve blockade. Therefore, understanding both an efficacious and safe approach to perioperative pain management remains essential along with an understanding of current and new emerging coagulations altering agents.

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