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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
18.2K
Combination of Superficial and Deep Blocks with Rivaroxaban.
Jacques E Chelly1, Benjamin Metais1, Dennis Schilling1
1Department of Anesthesiology, University of Pittsburgh Medical Center (UPMC).
Pain Medicine (Malden, Mass.)
|July 17, 2015
Summary
Combining nerve blocks with rivaroxaban for joint arthroplasty thromboprophylaxis showed no increased risk of major bleeding. Minor bleeding occurred, but was mostly unrelated to the nerve blocks or occurred before rivaroxaban initiation.
Area of Science:
- Anesthesiology
- Orthopedic Surgery
- Pharmacology
Background:
- Rivaroxaban is a Factor Xa inhibitor used for thromboprophylaxis after joint arthroplasty.
- Peripheral nerve blocks are common in joint arthroplasty procedures.
Purpose of the Study:
- To evaluate the risk of major bleeding associated with combined use of peripheral nerve blocks (single or continuous) and rivaroxaban for thromboprophylaxis in joint arthroplasty patients.
Main Methods:
- Analysis of 766 patients undergoing total hip or knee replacement.
- Inclusion of patients receiving femoral, sciatic, or lumbar plexus nerve blocks (alone or combined).
- Administration of rivaroxaban 10 mg once daily for postoperative thromboprophylaxis.
Main Results:
- No major bleeding events were linked to peripheral nerve block performance.
- Three patients experienced hematomas at the operated knee requiring surgical evacuation.
- Minor bleeding at the surgical site (12 patients) and block site (10 patients) was observed, with most block site bleeding occurring before rivaroxaban initiation.
Conclusions:
- The combination of deep and superficial nerve blocks with rivaroxaban thromboprophylaxis in joint arthroplasty does not elevate the risk of major bleeding.
- Peripheral nerve blocks can be safely used in conjunction with rivaroxaban for thromboprophylaxis.
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