RT Journal
A1 Larsen KD
T1 THe role of regional anesthesia in decreasing thromboembolism
JF JAMA
JO JAMA
YR 1989
FD June 23
VO 261
IS 24
SP 3552
OP 3552
DO 10.1001/jama.1989.03420240066024
UL http://dx.doi.org/10.1001/jama.1989.03420240066024
AB To the Editor.— 
    Dr Coon1 discusses the role of anticoagulants in decreasing the incidence of thromboembolism after total hip replacement, but he does not mention the contribution of anesthesia. Regional (spinal or epidural) anesthesia for orthopedic surgery significantly reduces the likelihood of thromboembolism compared with general anesthesia.2-4 However, in the case of surgery for a fractured hip, the improvement fades over a period of months, when other unidentified factors equalize the mortality after general vs regional anesthesia.5There is a possibility of increased blood loss when anticoagulants are used to avoid thromboembolism; regional anesthesia also reduces blood loss and the need for transfusion.2 For the patient in question for whom there might be difficulty in obtaining compatible blood, autologous donation of blood and a regional anesthetic should be considered as ways to decrease the risk of thromboembolism and the need for heterologous transfusion.