| Popis: |
Degenerative cardiovascular disease is associated with increasing age and represents the number one cause of mortality in the Western world. The urological patient population, consisting of a high percentage of elderly patients, makes concurrent cardiovascular disease a common finding. Atrial fibrillation, coronary stenting or mechanical heart valves frequently require some form of anticoagulation therapy and are commonly encountered. It is imperative for the anesthesiologist to be aware of the patient’s past medical history and have a thorough understanding of the pharmacokinetics of anticoagulant medications, especially since many urological procedures are performed using regional techniques. The risk of discontinuing these medications must be carefully weighed against the benefit of neuraxial anesthesia. Consequently, the decision to continue or withhold these medications must be made in a team approach involving the anesthesiologist, cardiologist and urologist. This chapter will discuss common medical conditions requiring anticoagulation and describe the agents used. |
