Incidence of neuraxial haematoma after total hip or knee surgery: RECORD programme (rivaroxaban vs. enoxaparin)

Autor:	W. Mueck, Martin Homering, J. V. Llau, Scott D. Berkowitz, N. Rosencher, A. Loewe
Rok vydání:	2013
Předmět:	medicine.medical_specialty Rivaroxaban education.field_of_study business.industry medicine.drug_class medicine.medical_treatment Anticoagulant Population Laminectomy Knee replacement General Medicine Arthroplasty Surgery law.invention Clinical trial Anesthesiology and Pain Medicine Randomized controlled trial law Anesthesia medicine business education medicine.drug
Zdroj:	Acta Anaesthesiologica Scandinavica. 57:565-572
ISSN:	0001-5172
DOI:	10.1111/aas.12069
Popis:	Background Patients receiving anticoagulants could be at higher risk of compressive haematoma with neuraxial anaesthesia use. The phase III RECORD programme compared rivaroxaban with enoxaparin for prevention of venous thromboembolism after total hip or knee replacement surgery in more than 12,500 patients. This observational analysis evaluated the risk of neuraxial haematoma after neuraxial anaesthesia in patients receiving rivaroxaban or enoxaparin using pooled RECORD1–4 data. Methods The incidences of intraspinal bleeding or haemorrhagic puncture were recorded as part of the criteria for major bleeding (the primary safety outcome in the RECORD studies). Incidences of allogeneic transfusion and venous thromboembolism by type of anaesthesia were also recorded. Results No compressive haematomas occurred in rivaroxaban-treated patients (10 mg once daily started 6–8 h after surgery) who underwent neuraxial anaesthesia (n = 4086). Among enoxaparin-treated patients (n = 4090), one compressive spinal haematoma requiring laminectomy occurred after epidural catheter removal in an elderly female patient with renal insufficiency undergoing total knee replacement. Total venous thromboembolism rates did not differ according to type of anaesthesia. Conclusion Although no issues were observed with the use of neuraxial anaesthesia in this population of 4086 patients receiving rivaroxaban after total hip or knee replacement, it is important to remain aware of the risk of compressive haematoma. This may be of particular concern in elderly patients with renal insufficiency receiving an anticoagulant predominantly eliminated via the kidneys.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::6d62ac9d1824ad7ec6b1dfa391f72647 https://doi.org/10.1111/aas.12069 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.