| Coagulation status using thromboelastography in patients receiving warfarin prophylaxis and epidural analgesia. | |
| | |
MedLine Citation:
|
PMID: 12393106 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
To determine the coagulation status of patients receiving postoperative warfarin and epidural analgesia using thromboelastography (TEG(R)).Prospective, observational, clinical study.Orthopedic postoperative division at a university hospital.52 ASA physical status II and III patients undergoing knee arthroplasty and receiving prophylactic warfarin and epidural analgesia.Patients' preoperative and postoperative coagulation status was determined by TEG(R). Daily TEG(R) parameters were obtained until the epidural catheter was removed. TEG(R) parameters include reaction time (R-time or time until the first significant levels of detectable clot formation), K-time (clot firmness), maximum amplitude (MA-clot strength), alpha angle (clot development), and coagulation index (overall coagulation). In addition, daily international normalized ratios (INRs) were obtained as per our routine practice. On the day of catheter removal reaction time was significantly increased compared with preoperative values (p < 0.0001), but it remained within normal ranges. There was no change in the coagulation index. However, INR was abnormal and significantly increased (INR = 1.48+/-0.3; p < 0.0001), compared with preoperative values, on the day when the epidural catheter was removed. When the epidural catheters are removed, overall coagulation status, as measured by TEG(R), and despite an elevated INR (mean INR <1.5), remained within normal limits in patients receiving low-dose warfarin prophylaxis. |
| | |
Authors:
|
David L Hepner; Mercedes Concepcion; Kodali Bhavani-Shankar |
Related Documents
:
|
3087936 - Increases in factor viii complex and fibrinolytic activity are dependent on exercise in... 2302076 - Heparin-coated equipment reduces complement activation during cardiopulmonary bypass in... 19462546 - Physical activity and pet ownership in year 3 of the health abc study. 7831666 - In vivo release of tissue-type plasminogen activator across the human forearm during me... 17365336 - Radiocaesium activity concentrations in potatoes in croatia after the chernobyl acciden... 11817556 - Diffusion of mepivacaine between adjacent synovial structures in the horse. part 1: for... |
Publication Detail:
|
Type: Clinical Trial; Controlled Clinical Trial; Journal Article |
Journal Detail:
|
Title: Journal of clinical anesthesia Volume: 14 ISSN: 0952-8180 ISO Abbreviation: J Clin Anesth Publication Date: 2002 Sep |
Date Detail:
|
Created Date: 2002-10-23 Completed Date: 2003-02-12 Revised Date: 2009-11-03 |
Medline Journal Info:
|
Nlm Unique ID: 8812166 Medline TA: J Clin Anesth Country: United States |
Other Details:
|
Languages: eng Pagination: 405-10 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. dhepner@partners.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Analgesia, Epidural* / adverse effects Anticoagulants / administration & dosage* Arthroplasty, Replacement, Knee / adverse effects Blood Coagulation / drug effects* Device Removal Humans International Normalized Ratio Pain, Postoperative / prevention & control Postoperative Complications / prevention & control* Prospective Studies Thrombelastography* Thrombosis / etiology, prevention & control* Warfarin / administration & dosage* |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 81-81-2/Warfarin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Altered apoptosis pattern during pharyngeal arch artery remodelling is associated with aortic arch m...
Next Document: Pain assessment following general anesthesia using the Toddler Preschooler Postoperative Pain Scale:...