Anticoagulantes e bloqueios espinhais

Itagyba Martins Miranda Chaves; Leandro Fellet Miranda Chaves

doi:10.1590/S0034-70942001000300006

Miscellaneous

Anticoagulantes e bloqueios espinhais

Anticoagulants and neuro-axis blockades

Itagyba Martins Miranda Chaves; Leandro Fellet Miranda Chaves

http://dx.doi.org/10.1590/S0034-70942001000300006 Braz J Anesthesiol, vol.51, n3, p.225-234, 2001

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Resumo

JUSTIFICATIVA E OBJETIVOS: Com o uso de anticoagulantes para tromboprofilaxia, a incidência de hematomas em anestesias espinhais aumentou. O objetivo desta revisão é verificar a ocorrência de casos de hematomas espinhais e sua correlação com o uso de drogas utilizadas na tromboprofilaxia. CONTEÚDO: São feitas algumas considerações clínicas e farmacológicas sobre as drogas utilizadas em tromboprofilaxia (cumarínicos, aspirina e heparina). São ressaltados os fatores de risco, particularmente aos relatos de casos de pacientes que desenvolveram hematoma peridural decorrente do uso simultâneo de heparina de baixo peso molecular e anestesia peridural. CONCLUSÕES: Existe importante associação entre hematoma peridural e distúrbios hemorrágicos, principalmente em pacientes em tratamento com anticoagulantes. O reconhecimento do aumento do risco da associação da anestesia peridural, da anestesia subaracnóidea, a continuada vigilância e a educação são fundamentais para evitar futuros casos.

Palavras-chave

ANTICOAGULANTES, COMPLICAÇÕES: hematoma peridural, TÉCNICAS ANESTÉSICAS, Regional: peridural, subaracnóidea

Abstract

BACKGROUND AND OBJECTIVES: The use of anticoagulants for thromboprophylaxis has increased the incidence of spinal blockades hematomas. This review aimed at checking the incidence of spinal hematomas and its correlation with anticoagulant drugs. CONTENTS: Some clinical and pharmacological considerations are made about thromboprophylactic drugs (cumarinics, aspirin and heparin). Risk factors are highlighted, especially those related to patients developing epidural hematomas due to the simultaneous use of low molecular weight heparin and epidural anesthesia. CONCLUSIONS: There is an important correlation between epidural hematomas and hemorrhagic disorders, especially in patients under anticoagulant therapy. The awareness of the increased risk associated to epidural and spinal anesthesia, as well as the continuous surveillance and education are fundamental to prevent future cases.

Keywords

ANESTHETIC TECHNIQUES, Regional: epidural, spinal block, ANTICOAGULANTS, COMPLICATIONS: epidural hematoma

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Anticoagulantes e bloqueios espinhais

Anticoagulants and neuro-axis blockades

Itagyba Martins Miranda Chaves; Leandro Fellet Miranda Chaves

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