Anaes Vivas · Regional / perioperative medicine
Perioperative VTE prophylaxis and neuraxial anaesthesia timing — viva
Structured oral examination station for perioperative-vte-prophylaxis-neuraxial.
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ANZCAFRCAEDAICABAFCAI
Prompt
Clinical stem centred on perioperative vte prophylaxis neuraxial. Crisis focus: New motor block after restart of LMWH with epidural in situ — suspected haematoma.
Opening
State the one-line plan: Balance VTE prevention (risk scores, LMWH/DOAC/mechanical methods) against neuraxial haematoma risk using ASRA principles: drug class, dose, renal function, combination therapy, and last-dose-to-needle / catheter-removal timing per current tables.[1]
References5ShowHide
- [1]Horlocker TT et al. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: ASRA Evidence-Based Guidelines (Fourth Edition). Regional Anesthesia and Pain Medicine, 2018.PMID 29561531
- [2]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2). Lancet, 2010.PMID 20554319
- [3]Neal JM et al. Third ASRA Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. Regional Anesthesia and Pain Medicine, 2018.PMID 29356773
- [4]Gogarten W et al. Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. European Journal of Anaesthesiology, 2010.PMID 20890208
- [5]Falck-Ytter Y et al. Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012.PMID 22315265