Neuraxial Anesthesia and Antithrombotic Treatment

Abstract

Spinal hematoma after neuraxial anesthesia is an uncommon but devastating complication. Since perioperative use of anticoagulants and antiplatelet drugs has recently increased, there is a growing concern regarding the safety of neuraxial anesthesia in patients receiving antithrombotic treatment. To improve patient safety, a guideline for performing regional anesthesia in those patients was recently published in Japan. The actual incidence of hematoma associated with neuraxial anesthesia is difficult to measure. In addition, since no prospective randomized study has been conducted to assess the relative risk of spinal hematoma associated with anticoagulants and antiplatelet drugs after neuraxial anesthesia, the guideline is based on previous reviews, case series, case reports, and guidelines published abroad.