Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition).

This third edition of the ASRA guidelines had been awaited for a long time. The previous versions have been updated and now the text provides new, detailled comments and evidence-based graded recommendations. As the famous worldwide ACCP guidelines for venous thromboembolism prophylaxis, the ASRA guidelines represent a unique reference in the very conflicting anesthesiology environment.

The importance and high quality of this text preclude any major criticism. However, the reader may find the approach chosen for the new antithrombotic agents a little bit conservative. This remark also applies to the management of peripheral blocks for which ASRA states that recommendations regarding neuraxial techniques should be applied similarly (Grade 1C), although the bleeding risk may have very different consequences.

– Charles-Marc Samama