[Thromboprophylaxis in the perioperative: implications for technical regional anesthetic]

Thromboprophylaxis in surgical patients requires specific measures to implement regional anesthesia techniques. In this regard the current clinical practice guidelines of anesthesiology summarizes the recommendations of the review of current evidence.

We must recognize the general guidelines for thromboprophylaxis and impact modifiers of coagulation for the Surgical Team to implement the actions for each specific patient.

The most feared event by anesthesiologists is the spinal hematoma, but given its rarity there is a prospective randomized study, nor is there currently a laboratory model. Therefore the consensus established clinical practice recommendations for making a decision to anesthesia / analgesia epidural or spinal or peripheral nerve and the time of catheter removal in a patient receiving coagulation modifiers should be based on a individual analysis, weighing the small but definite risk of neuraxial hematoma with the benefits of regional anesthesia for a specific patient.

the coagulation status should be evaluated and optimized at the time of placement of a needle anesthesia or continue either epidural, spinal or peripheral nerve blockade to continue prophylaxis as a priority without minimizing the risk of serious complications such as spinal bleeding.