Practice advisory on the bleeding risks for peripheral nerve and interfascial plane blockade: evidence review and expert consensus

AbstractThe risk of bleeding complications during regional anesthesia procedures is a significant patient safety consideration. Nevertheless, existing literature provides limited guidance on the stratification of bleeding risk for peripheral nerve and newly described interfascial plane blocks. Our objective was to produce an evidence-based consensus advisory that classifies bleeding risks in patients undergoing regional peripheral nerve and interfascial plane block procedures. This advisory is intended to facilitate clinical decision-making in conjunction with national or local guidelines and to guide consideration for appropriate alterations to anticoagulation regimens before specific regional anesthesia procedures. In pursuit of this goal, the Regional Anesthesia and Acute Pain Section of the Canadian Anesthesiologists Society (CAS) assembled a panel of seven Canadian experts to classify the risk of bleeding complications associated with regional peripheral nerve and interfascial plane blocks. At the 75th annual meeting of the CAS in June 2018, the panel ’s expert opinion was finalized and the published literature was quantified within an organized framework. All common peripheral nerve and interfascial plane blocks were categorized into “low risk”, “intermediate risk”, and “high risk” based on the literature evidence, bleeding risk sc ores, and consensus opinion (in that order of priority). Clinical data is often limited, so readers of this consensus report s...

Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research