Antiplatelet drugs and intraoperative haemorrhage Current literature demonstrates that there is less risk involved in maintaining anti-aggregant therapy (which might imply to transfuse more the patients), than in stopping it, which then increases dangerously the risk of coronary thrombosis. Aspirin, as a secondary preventive drug, should not be interrupted. Clopidogrel is essential for protection against thrombosis in areas where the endothelium is not intact. Unless there is a high hemorrhagic risk in closed cavities (intracranial surgery), clopidogrel should not be interrupted. Furthermore, any surgical intervention increasing the coagulability of the platelets, it seems particularly dangerous to stop such medication perioperatively.
Download full-text PDF |
Source |
---|
Global Spine J
January 2025
Department of Orthopedics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Study Design: Retrospective cohort study.
Objectives: Spinal surgeons face a dilemma regarding the continuation or discontinuation of antiplatelet agents during the perioperative period. Guidelines recommend considering the balance between thrombotic and bleeding risks.
Surg Endosc
January 2025
Clinica Chirurgica, Department of Experimental and Clinical Medicine, Section of Surgical Sciences, Polytechnic University of Marche, Ancona, Italy.
Introduction: Altered vascular microcirculation is recognized as a risk factor for anastomotic leakage (AL) in colorectal surgery. However, few studies evaluated its impact on AL using different devices, with heterogeneous results. The present study reported the initial experience measuring gut microcirculatory density and flow with the aid of incidence dark-field (IDF) videomicroscopy (Cytocam, Braedius, Amsterdam, The Netherlands) comparing its operative outcome using a propensity score matching (PSM) model based on age, gender, and Charlson Comorbidity Index (CCI).
View Article and Find Full Text PDFHeliyon
January 2025
Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188Shizi Street, Suzhou, 215006, Jiangsu Province, China.
Objective: Gliomas are the most common intracranial tumors with the highest degree of malignancy. Disturbed cholesterol metabolism is one of the key features of many malignant tumors, including gliomas. This study aimed to investigate the significance of cholesterol metabolism-related genes in prognostic prediction and in guiding individualized treatment of patients with gliomas.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Optimal fluid strategy for laparoscopic donor nephrectomy (LDN) remains unclear. LDN has been a domain for liberal fluid management to ensure graft perfusion, but this can result in adverse outcomes due to fluid overload. We compared postoperative outcome of living kidney donors according to the intraoperative fluid management.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology and Intensive Care Medicine, Halland Hospital Halmstad, Lasarettsvägen, Halmstad, SE-30581, Sweden.
Background: Patients undergoing general anesthesia are more frequently monitored for depth of anesthesia using processed electroencephalography. Opioid-free anesthesia is nowadays an accepted modality for general anesthesia, however it is unclear how to interpret data from processed electroencephalography when using a mixture of non-opioid anesthetic drugs. Our objective was to describe density spectral array patterns and compare processed encephalographic data indices between opioid-free and routine opioid based anesthesia.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!