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Array ( [id] => 889 [catid] => 291 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/889.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => With unanticipated administration with indwelling catheter, we suggest that dabigatran dosing be held for 34 to 36 hours or the dTT or ECT assessed before the catheter is removed. (2C) [laiyuan] => 对于使用留置导管的计划外用药，建议达比加群继续用药 34-36 小时，或在拔除导管前评估血浆稀释凝血酶时间或蛇静脉酶凝结时间。（证据质量：低；推荐强度：弱推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
对于使用留置导管的计划外用药，建议达比加群继续用药 34-36 小时，或在拔除导管前评估血浆稀释凝血酶时间或蛇静脉酶凝结时间。（证据质量：低；推荐强度：弱推荐）

With unanticipated administration with indwelling catheter, we suggest that dabigatran dosing be held for 34 to 36 hours or the dTT or ECT assessed before the catheter is removed. (2C)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 890 [catid] => 291 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/890.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => We suggest that dabigatran be discontinued 120 hours in patients with a CrCl of 30 to 49 mL/min. Consider checking dTT or ECT if less than 120 hours. An acceptable level of residual dabigatran activity to proceed with neuraxial block remains undetermined. (2C) [laiyuan] => 建议对于39mL/min≤肌酐清除率＜49mL/min的患者，达比加群应停药120小时。如果停药不足120小时，可考虑检查血浆稀释凝血酶时间或蛇静脉酶凝结时间。可进行椎管内阻滞时可接受的达比加群残留活性水平仍未确定。（证据质量：低；推荐强度：弱推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
建议对于39mL/min≤肌酐清除率＜49mL/min的患者，达比加群应停药120小时。如果停药不足120小时，可考虑检查血浆稀释凝血酶时间或蛇静脉酶凝结时间。可进行椎管内阻滞时可接受的达比加群残留活性水平仍未确定。（证据质量：低；推荐强度：弱推荐）

We suggest that dabigatran be discontinued 120 hours in patients with a CrCl of 30 to 49 mL/min. Consider checking dTT or ECT if less than 120 hours. An acceptable level of residual dabigatran activity to proceed with neuraxial block remains undetermined. (2C)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 891 [catid] => 291 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/891.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => We suggest that dabigatran be discontinued 96hours inpatients with a CrCl of 50to79mL/min. Consider checking dTT or ECT if less than 96 hours. An acceptable level of residual dabigatran activity to proceed with neuraxial block remains undetermined. (2C) [laiyuan] => 建议对于50mL/min≤肌酐清除率＜79mL/min的患者，达比加群应停药96小时。如果停药不足96小时，可考虑检查血浆稀释凝血酶时间或蛇静脉酶凝结时间。可进行椎管内阻滞时可接受的达比加群残留活性水平仍未确定。（证据质量：低；推荐强度：弱推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
建议对于50mL/min≤肌酐清除率＜79mL/min的患者，达比加群应停药96小时。如果停药不足96小时，可考虑检查血浆稀释凝血酶时间或蛇静脉酶凝结时间。可进行椎管内阻滞时可接受的达比加群残留活性水平仍未确定。（证据质量：低；推荐强度：弱推荐）

We suggest that dabigatran be discontinued 96hours inpatients with a CrCl of 50to79mL/min. Consider checking dTT or ECT if less than 96 hours. An acceptable level of residual dabigatran activity to proceed with neuraxial block remains undetermined. (2C)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 892 [catid] => 291 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/892.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => We suggest that dabigatran be discontinued 72hours in patients with a CrCl 80mL/min or greater. Consider checking dTT or ecarin clotting time (ECT) if less than 72 hours. An acceptable level of residual dabigatran activity to proceed with neuraxial block remains undetermined. (2C) [laiyuan] => 建议对于肌酐清除率≥ 80mL/min 的患者停用达比加群72小时。如果停用不足72小时，可考虑检查血浆稀释凝血酶时间或蛇静脉酶凝结时间。可进行椎管内阻滞时可接受的达比加群残留活性水平仍未确定。（证据质量：低；推荐强度：弱推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
建议对于肌酐清除率≥ 80mL/min 的患者停用达比加群72小时。如果停用不足72小时，可考虑检查血浆稀释凝血酶时间或蛇静脉酶凝结时间。可进行椎管内阻滞时可接受的达比加群残留活性水平仍未确定。（证据质量：低；推荐强度：弱推荐）

We suggest that dabigatran be discontinued 72hours in patients with a CrCl 80mL/min or greater. Consider checking dTT or ecarin clotting time (ECT) if less than 72 hours. An acceptable level of residual dabigatran activity to proceed with neuraxial block remains undetermined. (2C)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 893 [catid] => 291 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/893.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => In patients receiving parenteral thrombin inhibitors, we recommend against the performance of neuraxial techniques. (2C) [laiyuan] => 对于接受肠外凝血酶抑制剂治疗的患者，我们建议不要使用神经介入技术。（证据质量：低；推荐强度：弱推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
对于接受肠外凝血酶抑制剂治疗的患者，我们建议不要使用神经介入技术。（证据质量：低；推荐强度：弱推荐）

In patients receiving parenteral thrombin inhibitors, we recommend against the performance of neuraxial techniques. (2C)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 894 [catid] => 303 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/894.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => In patients receiving C-dose warfarin therapy during epidural analgesia, we suggest that their INR be monitored on a daily basis. (2C) [laiyuan] => 对于硬膜外镇痛期间接受小剂量华法林治疗的患者，建议每天监测其 INR。（证据质量：低；推荐强度：弱推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
对于硬膜外镇痛期间接受小剂量华法林治疗的患者，建议每天监测其 INR。（证据质量：低；推荐强度：弱推荐）

In patients receiving C-dose warfarin therapy during epidural analgesia, we suggest that their INR be monitored on a daily basis. (2C)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 895 [catid] => 303 [title] => Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/895.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:16 [updatetime] => 2024-01-11 15:14:16 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => American Society of Regional Anesthesia and Pain M [pdf] => [tjyjyw] => [lyyw] => In patients with an INR of greater than 3, we recommend that the warfarin dose be held or reduced in patients with indwelling neuraxial catheters. (1A) [laiyuan] => 对于INR≥3 的患者，推荐留置椎管内导管的患者保持或减少华法林剂量。（证据质量：高；推荐强度：强推荐） [znzldj] => B [_inputtime] => 1704957256 [_updatetime] => 1704957256 [_nrjc] => [_nrsh] => )
推荐意见
对于INR≥3 的患者，推荐留置椎管内导管的患者保持或减少华法林剂量。（证据质量：高；推荐强度：强推荐）

In patients with an INR of greater than 3, we recommend that the warfarin dose be held or reduced in patients with indwelling neuraxial catheters. (1A)

证据评价方法：GRADE

指南质量等级：B

年份：2018

国家：American Society of Regional Anesthesia and Pain M

来源 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition)
阅读
Array ( [id] => 841 [catid] => 39 [title] => 加速康复外科中国专家共识暨路径管理指南（2025）：胰十二指肠切除术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/841.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:15 [updatetime] => 2024-01-11 15:14:15 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => 中华医学会外科学分会 中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 胰腺外科手术中采用肺保护性通气策略。（证据级别：高；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957255 [_updatetime] => 1704957255 [_nrjc] => [_nrsh] => )
推荐意见
胰腺外科手术中采用肺保护性通气策略。（证据级别：高；推荐强度：强推荐）

证据评价方法：GRADE

指南质量等级：C

年份：2018

国家：中华医学会外科学分会 中华医学会麻醉学分会

来源 加速康复外科中国专家共识暨路径管理指南（2025）：胰十二指肠切除术部分
阅读
Array ( [id] => 842 [catid] => 35 [title] => 加速康复外科中国专家共识暨路径管理指南（2026）：胰十二指肠切除术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/842.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:15 [updatetime] => 2024-01-11 15:14:15 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => 中华医学会外科学分会 中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 全身应用阿片类药物和∕或非甾体抗炎药，联合椎管内麻醉或周围神经阻滞或切口浸润是此类病人有效的术后镇痛方法，应充分权衡各种方法和药物的收益与风险。（证据级别：高；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957255 [_updatetime] => 1704957255 [_nrjc] => [_nrsh] => )
推荐意见
全身应用阿片类药物和∕或非甾体抗炎药，联合椎管内麻醉或周围神经阻滞或切口浸润是此类病人有效的术后镇痛方法，应充分权衡各种方法和药物的收益与风险。（证据级别：高；推荐强度：强推荐）

证据评价方法：GRADE

指南质量等级：C

年份：2018

国家：中华医学会外科学分会 中华医学会麻醉学分会

来源 加速康复外科中国专家共识暨路径管理指南（2026）：胰十二指肠切除术部分
阅读
Array ( [id] => 843 [catid] => 37 [title] => 加速康复外科中国专家共识暨路径管理指南（2027）：胰十二指肠切除术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/843.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:14:15 [updatetime] => 2024-01-11 15:14:15 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2018 [guojia] => 中华医学会外科学分会 中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 围术期采用合理的措施预防术后恶心呕吐。 高危病人（＞3个危险因素）应采取多模式预防术后恶心呕吐（证据级别：低；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957255 [_updatetime] => 1704957255 [_nrjc] => [_nrsh] => )
推荐意见
围术期采用合理的措施预防术后恶心呕吐。 高危病人（＞3个危险因素）应采取多模式预防术后恶心呕吐（证据级别：低；推荐强度：强推荐）

证据评价方法：GRADE

指南质量等级：C

年份：2018

国家：中华医学会外科学分会 中华医学会麻醉学分会

来源 加速康复外科中国专家共识暨路径管理指南（2027）：胰十二指肠切除术部分
阅读

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