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Safety of Tranexamic Acid in Hip and Knee Arthroplasty in High-risk Patients
ConclusionsAlthough effective in reducing blood transfusions, tranexamic acid is not associated with increased complications, irrespective of patient high-risk status at baseline.Editor ’s PerspectiveWhat We Already Know about This TopicThe use of tranexamic acid to decrease blood loss during lower-extremity arthroplasty is commonplaceSafety concerns remain for patients with a history of thromboembolic, cardiovascular, renal, or neurologic comorbiditiesWhat This Article Tells Us That Is NewNational administrative data from more than 500 hospitals and 40,000 patients demonstrate that approximately half of high-risk patien...
Source: Anesthesiology - June 9, 2021 Category: Anesthesiology Source Type: research

Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries A Retrospective Cohort Analysis
Conclusions An active cannabis use disorder is associated with an increased perioperative risk of myocardial infarction.Editor ’s PerspectiveWhat We Already Know about This TopicCannabis is known to have cardiovascular and psychoactive effectsThe association between active cannabis use disorder and postoperative outcomes remains unclearWhat This Article Tells Us That Is NewIn the United States, administrative data demonstrate that cannabis use disorder has increased in prevalence from 2010 to 2015Active cannabis use disorder is not associated with a change in overall perioperative morbidity, mortality, length of stay, or...
Source: Anesthesiology - March 10, 2020 Category: Anesthesiology Source Type: research

Four-factor Prothrombin Complex Concentrate for the Management of Patients Receiving Direct Oral Activated Factor X Inhibitors
Direct oral anticoagulants (DOACs) have been approved for the prevention of stroke and systemic embolism in atrial fibrillation, treatment and secondary prevention of venous thromboembolism (VTE), and thromboprophylaxis after major orthopedic surgery. DOACs achieve anticoagulation by inhibiting specific coagulation factors; apixaban, betrixaban, edoxaban, and rivaroxaban inhibit activated factor X, whereas dabigatran inhibits thrombin (factor IIa). In contrast to vitamin K antagonists such as warfarin, DOACs have more predictable pharmacokinetics and pharmacodynamics and fewer interactions with other medications and food, ...
Source: Anesthesiology - October 15, 2019 Category: Anesthesiology Source Type: research

Association of Testosterone Replacement Therapy and the Incidence of a Composite of Postoperative In-hospital Mortality and Cardiovascular Events in Men Undergoing Noncardiac Surgery
Conclusions Preoperative testosterone is not associated with an increased incidence of a composite of postoperative in-hospital mortality and cardiovascular events.
Source: Anesthesiology - August 15, 2017 Category: Anesthesiology Source Type: research