The American Society of Regional Anesthesiologists and Pain Medicine (ASRA) recently published specific recommendations to reduce the risk of bleeding and neurological injury in patients on anticoagulant and antiplatelet medications. These guidelines stratify interventional spine and pain procedures according to potential bleeding risk as low-, intermediate-, and high-risk procedures. Recommendations were evidence-based when available and pharmacology-driven otherwise. Although ASRA guidelines provide sound recommendations, a case-by-case approach must be taken to balance between bleeding and thromboembolism risk to safely manage pain interventions in patients on antiplatelet/anticoagulant therapy.
KeywordsAnticoagulation Antiplatelets Antithrombotics Bleeding Hematoma Neuraxial Peripheral nerve blockade
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