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J Arthroplasty. 2008 Apr;23(3):350-4. doi: 10.1016/j.arth.2007.05.045.

Thromboprophylaxis and peripheral nerve blocks in patients undergoing joint arthroplasty.

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Department of Anesthesiology, Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15232, USA.


This study was designed to assess the risk of hematoma related to the combination of peripheral nerve blocks and thromboprophylaxis. A total of 3588 patients undergoing joint arthroplasty were included. Blocks performed included continuous lumbar plexus, continuous femoral, and continuous or single sciatic. The perineural catheters were removed on postoperative days 2 or 3. A total of 6935 blocks were performed in patients receiving warfarin (50.0%), fondaparinux (12.8%), deltaparin (11.6%), enoxaparin (1.8%), and aspirin (23.8%). In this patient population, no perineural hematoma was recorded. Our data provide evidence that continuous/single peripheral nerve blocks can be safely performed before thromboprophylaxis initiation, and perineural catheters can be safely removed while the patient is receiving thromboprophylaxis and/or aspirin.

[Indexed for MEDLINE]

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