Anaesthesia
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We propose recommendations to reduce the risk of haemorrhagic events associated with regional anaesthesia in patients treated with newer anticoagulants after orthopaedic surgery. The risk/benefit ratio should be individualised for each patient according to the type and dose of anticoagulant, the type of regional anaesthesia and patient risk factors. ⋯ After removing a catheter or after a haemorrhagic puncture, the timing of the next anticoagulant injection should be based on the time required for an anticoagulant dose to reach maximum activity. Vigilance remains paramount during the initial days after removal of a neuraxial catheter.
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Interpleural blockade is effective in treating unilateral surgical and non-surgical pain from the chest and upper abdomen in both the acute and chronic settings. It has been shown to provide safe, high-quality analgesia after cholecystectomy, thoracotomy, renal and breast surgery, and for certain invasive radiological procedures of the renal and hepatobiliary systems. ⋯ The technique is simple to learn and has both few contra-indications and a low incidence of complications. In the second of two reviews, the authors cover the applications, complications, contra-indications and areas for future research.