Thrombelastography as an aid to regional anesthesia: preliminary communication

Thrombelastography (TEG), a less commonly available technique used to assess hemostatic function, has recently gained popularity. Analysis of TEG yields qualitative information about platelet function, thromboplastin generation and their interaction with the intrinsic cascade to form a stable clot. Additional information is obtained about fibrinogen and Factor XIII levels as well as the fibrinolytic system. TEG has been shown to be more sensitive and accurate than traditional coagulation tests at both predicting and treating coagulopathies. We report here three cases in which TEG was used to assess hemostatic function in patients at risk for bleeding prior to the induction of regional anesthesia. In all three cases, traditional tests were inadequate to predict the safe practice of regional anesthesia. TEG provided this information and regional anesthesia was successfully employed.