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Neuraxial anesthesia and timing of heparin administration in patients undergoing surgery for congenital heart disease using cardiopulmonary bypass.
J Cardiothorac Vasc Anesth. 2012 Aug; 26(4):581-4.JC

Abstract

OBJECTIVE

The goal of this review was to add to the existing literature documenting the safety of performing neuraxial techniques in patients who are subsequently fully heparinized, with particular emphasis on the timing of heparin administration. This will help improve risk estimation and possibly lead to a more widespread use of neuraxial anesthesia in patients undergoing cardiac surgery.

DESIGN

Retrospective chart review.

SETTING

Single tertiary-care university hospital.

PARTICIPANTS

All patients undergoing surgery for congenital heart diseases during a 5-year period.

INTERVENTIONS

The medical records of all patients undergoing surgery for congenital heart diseases during a 5-year period were reviewed for any complications related to the use of neuraxial anesthesia. Furthermore, the interval from neuraxial anesthesia to heparinization for cardiopulmonary bypass was examined.

RESULTS

In total, 714 patients were identified who had neuraxial anesthesia administered before full heparinization for cardiopulmonary bypass. No cases of symptomatic spinal or epidural hematomas occurred. Further analysis showed that the interval from neuraxial anesthesia to full heparinization was <1 hour in 466 patients.

CONCLUSIONS

No complications related to neuraxial anesthesia were found in a series of 714 patients undergoing surgery for congenital heart disease using cardiopulmonary bypass, including 466 patients in whom the interval from neuraxial anesthesia to full heparinization was <1 hour.

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Authors+Show Affiliations

Weiner MM
Department of Anesthesiology, The Mount Sinai School of Medicine, New York, NY, USA. menachem.weiner@mountsinai.org
Rosenblatt MA
No affiliation info available
Mittnacht AJ
No affiliation info available

MeSH

AdolescentAdultAnesthesia, EpiduralAnesthesia, SpinalAnticoagulantsCardiopulmonary BypassChildChild, PreschoolFemaleHeart Defects, CongenitalHeparinHumansInfantMaleMiddle AgedRetrospective StudiesTime Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22155166

Citation

Weiner, Menachem M., et al. "Neuraxial Anesthesia and Timing of Heparin Administration in Patients Undergoing Surgery for Congenital Heart Disease Using Cardiopulmonary Bypass." Journal of Cardiothoracic and Vascular Anesthesia, vol. 26, no. 4, 2012, pp. 581-4.
Weiner MM, Rosenblatt MA, Mittnacht AJ. Neuraxial anesthesia and timing of heparin administration in patients undergoing surgery for congenital heart disease using cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2012;26(4):581-4.
Weiner, M. M., Rosenblatt, M. A., & Mittnacht, A. J. (2012). Neuraxial anesthesia and timing of heparin administration in patients undergoing surgery for congenital heart disease using cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia, 26(4), 581-4. https://doi.org/10.1053/j.jvca.2011.10.010
Weiner MM, Rosenblatt MA, Mittnacht AJ. Neuraxial Anesthesia and Timing of Heparin Administration in Patients Undergoing Surgery for Congenital Heart Disease Using Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth. 2012;26(4):581-4. PubMed PMID: 22155166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuraxial anesthesia and timing of heparin administration in patients undergoing surgery for congenital heart disease using cardiopulmonary bypass. AU - Weiner,Menachem M, AU - Rosenblatt,Meg A, AU - Mittnacht,Alexander J C, Y1 - 2011/12/11/ PY - 2011/08/17/received PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2012/12/10/medline SP - 581 EP - 4 JF - Journal of cardiothoracic and vascular anesthesia JO - J Cardiothorac Vasc Anesth VL - 26 IS - 4 N2 - OBJECTIVE: The goal of this review was to add to the existing literature documenting the safety of performing neuraxial techniques in patients who are subsequently fully heparinized, with particular emphasis on the timing of heparin administration. This will help improve risk estimation and possibly lead to a more widespread use of neuraxial anesthesia in patients undergoing cardiac surgery. DESIGN: Retrospective chart review. SETTING: Single tertiary-care university hospital. PARTICIPANTS: All patients undergoing surgery for congenital heart diseases during a 5-year period. INTERVENTIONS: The medical records of all patients undergoing surgery for congenital heart diseases during a 5-year period were reviewed for any complications related to the use of neuraxial anesthesia. Furthermore, the interval from neuraxial anesthesia to heparinization for cardiopulmonary bypass was examined. RESULTS: In total, 714 patients were identified who had neuraxial anesthesia administered before full heparinization for cardiopulmonary bypass. No cases of symptomatic spinal or epidural hematomas occurred. Further analysis showed that the interval from neuraxial anesthesia to full heparinization was <1 hour in 466 patients. CONCLUSIONS: No complications related to neuraxial anesthesia were found in a series of 714 patients undergoing surgery for congenital heart disease using cardiopulmonary bypass, including 466 patients in whom the interval from neuraxial anesthesia to full heparinization was <1 hour. SN - 1532-8422 UR - https://www.unboundmedicine.com/medline/citation/22155166/Neuraxial_anesthesia_and_timing_of_heparin_administration_in_patients_undergoing_surgery_for_congenital_heart_disease_using_cardiopulmonary_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-0770(11)00713-0 DB - PRIME DP - Unbound Medicine ER -