[Regional anesthesia techniques and hemostasis disorders]

Hereditary or acquired disorders of coagulation often lead to the question of whether it is permissible to perform regional anaesthetic techniques. Disorders of coagulation that cannot be treated are generally contraindications to regional anaesthesia. The history and clinical findings represent the most important measures before employing a regional anaesthetic technique. The use of anticoagulant agents as well as non-steroidal antirheumatics and acetylsalicylic acid should be determined. In addition to coagulation studies, the use of regional anaesthetic techniques during simultaneous anticoagulant treatment requires a clear arrangement with the operative department in question. In most instances there will be a tendency to perform general anaesthesia, however, considering the fact that general anaesthesia is also associated with complications (intratracheal bleeding), regional anaesthesia represents an alternative method, especially in patients with significant concomitant disorders. In this situation the possibility of peripheral nerve blockade should be taken into consideration.