2022
Low Molecular Weight Heparin, Unfractionated Heparin and Neuraxial Anaesthesia
Combs D, Leffert L. Low Molecular Weight Heparin, Unfractionated Heparin and Neuraxial Anaesthesia. 2022, 329-335. DOI: 10.1007/978-3-030-72487-0_49.Peer-Reviewed Original Research
2021
Pragmatic Approach to Neuraxial Anesthesia in Obstetric Patients With Disorders of the Vertebral Column, Spinal Cord, and Neuromuscular System
Walsh E, Zhang Y, Madden H, Lehrich J, Leffert L. Pragmatic Approach to Neuraxial Anesthesia in Obstetric Patients With Disorders of the Vertebral Column, Spinal Cord, and Neuromuscular System. Obstetric Anesthesia Digest 2021, 41: 164-165. DOI: 10.1097/01.aoa.0000796068.53863.3d.Peer-Reviewed Original Research
2020
Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system
Walsh E, Zhang Y, Madden H, Lehrich J, Leffert L. Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system. Regional Anesthesia & Pain Medicine 2020, 46: 258-267. PMID: 33115718, DOI: 10.1136/rapm-2020-101792.Peer-Reviewed Original ResearchConceptsNeuraxial anesthesiaObstetric patientsSpinal cordCesarean delivery anesthesiaCesarean deliveryLabor analgesiaNeuraxial analgesiaVertebral columnCase seriesGeneral anesthesiaObstetrical patientsRetrospective studyDelivery anesthesiaPatient injuryAnesthesiaPatient harmPatientsNarrative reviewAvailable evidenceUnwarranted fearsNeuromuscular systemAdditional riskPresent unique challengesAnalgesiaCordLumbar Neuraxial Procedures in Thrombocytopenic Patients Across Populations: A Systematic Review and Meta-analysis
Bauer M, Toledano R, Houle T, Beilin Y, MacEachern M, McCabe M, Rector D, Cooper J, Gernsheimer T, Landau R, Leffert L. Lumbar Neuraxial Procedures in Thrombocytopenic Patients Across Populations: A Systematic Review and Meta-analysis. Obstetric Anesthesia Digest 2020, 40: 118-118. DOI: 10.1097/01.aoa.0000693644.32975.42.Peer-Reviewed Original ResearchNeuraxial anesthetic proceduresSpinal epidural hematomaEpidural hematomaThrombocytopenic patientsNeuraxial proceduresAnesthetic proceduresSystematic reviewThreshold platelet countCesarean deliveryFetal factorsNeuraxial anesthesiaGeneral anesthesiaPlatelet countSide effectsMeta-AnalysisHematomaPatientsAnesthesiaReviewPopulation
2019
Don’t throw the baby out with the bathwater: spinal-epidural hematoma in the setting of obstetric thromboprophylaxis and neuraxial anesthesia
Leffert L, Horlocker T, Landau R. Don’t throw the baby out with the bathwater: spinal-epidural hematoma in the setting of obstetric thromboprophylaxis and neuraxial anesthesia. International Journal Of Obstetric Anesthesia 2019, 39: 7-11. PMID: 31202587, DOI: 10.1016/j.ijoa.2019.05.001.Peer-Reviewed Original Research
2018
Anesthetic Treatment of Cardiac Disease During Pregnancy
Cohen KM, Minehart RD, Leffert LR. Anesthetic Treatment of Cardiac Disease During Pregnancy. Current Treatment Options In Cardiovascular Medicine 2018, 20: 66. PMID: 30019160, DOI: 10.1007/s11936-018-0657-4.Peer-Reviewed Original ResearchPhysiologic changesCardiac diseaseCardiac pathologyMaternal-fetal medicine specialistsNormal physiologic changesInterdisciplinary care teamFetal medicine specialistsHemodynamic goalsObstetric indicationsPregnant patientsCesarean deliveryNeuraxial analgesiaAnesthetic managementCoronary diseaseMedical therapyNeuraxial anesthesiaValvular diseaseAnesthetic approachVasoactive agentsPeripartum periodCare teamAnesthetic treatmentMaternal wellbeingMedicine specialistsCardiothoracic surgeonsThe Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants
Leffert L, Butwick A, Carvalho B, Arendt K, Bates SM, Friedman A, Horlocker T, Houle T, Landau R, Dubois H, Fernando R, Houle T, Kopp S, Montgomery D, Pellegrini J, Smiley R, Toledo P. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesthesia & Analgesia 2018, 126: 928-944. PMID: 29099429, DOI: 10.1213/ane.0000000000002530.Peer-Reviewed Original ResearchConceptsHigh-dose anticoagulantsConsensus statementMaternal deathsObstetric anesthesiaNeuraxial proceduresPerinatology Consensus StatementPharmacodynamics of anticoagulantsUse of thromboprophylaxisRisk-benefit discussionsKey preventive measuresObstetric populationObstetric surgeryCesarean deliveryNeuraxial analgesiaVenous thromboembolismAnesthetic managementObstetric patientsDifficult airwayNeuraxial anesthesiaGeneral anesthesiaPostpartum womenPregnant womenFetal harmPostpartum periodLeading causeNeuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low–Molecular-Weight Heparin
Leffert L, Dubois H, Butwick A, Carvalho B, Houle T, Landau R. Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low–Molecular-Weight Heparin. Obstetric Anesthesia Digest 2018, 38: 3-4. DOI: 10.1097/01.aoa.0000529964.63597.d5.Peer-Reviewed Original ResearchSpinal epidural hematomaObstetric patientsNeuraxial anesthesiaWeight heparinVenous thromboembolismCesarean deliveryEpidural hematomaPregnant womenNeuraxial blockadeNational guidelinesPatientsThromboprophylaxisHeparinAnesthesiaSafe useWomenLow-MolecularThromboembolismHematomaBlockadeReview reportsPresent review reports
2017
Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin
Leffert LR, Dubois HM, Butwick AJ, Carvalho B, Houle TT, Landau R. Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin. Anesthesia & Analgesia 2017, 125: 223-231. PMID: 28628578, DOI: 10.1213/ane.0000000000002173.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnesthesia, ConductionAnesthesia, ObstetricalAnesthesiologyAnestheticsAnticoagulantsCesarean SectionDelivery, ObstetricFemaleHematoma, Epidural, SpinalHeparinHeparin, Low-Molecular-WeightHumansMiddle AgedNerve BlockPregnancyPregnancy Complications, CardiovascularThrombosisYoung AdultConceptsSpinal epidural hematomaCases of SEHNeuraxial anesthesiaObstetric patientsVenous thromboembolismWeight heparinAnesthesia Closed Claims Project databaseSystematic reviewPractice changePostpartum venous thromboembolismVaginal delivery hospitalizationsWeight heparin doseRisk of thromboembolismLarge-scale registriesMajority of womenEnglish-language studiesAnticoagulated womenDelivery hospitalizationsPharmacological thromboprophylaxisAnticoagulant doseCesarean deliveryEpidural hematomaHeparin doseVaginal deliveryGeneral anesthesiaAnesthetic and Obstetric Management of Placenta Accreta: Clinical Experience and Available Evidence
Toledano R, Leffert L. Anesthetic and Obstetric Management of Placenta Accreta: Clinical Experience and Available Evidence. Current Anesthesiology Reports 2017, 7: 93-102. DOI: 10.1007/s40140-017-0200-2.Peer-Reviewed Original ResearchPlacenta accretaObstetric managementManagement of womenCesarean delivery rateTiming of deliveryPeripartum hysterectomyAdherent placentaMaternal hemorrhageNeuraxial anesthesiaHigh morbidityConsensus guidelinesPatient preferencesLeading causeMultidisciplinary planningCommon causeAccretaClinician experienceAntenatal diagnosisClinical experienceMultidisciplinary teamInterventional radiologyEmergency deliveryAvailable evidenceMorbidityCurrent literatureIntegrating the New Thromboprophylaxis Guidelines Into Obstetric Anesthesia Practice
Leffert L, Landau R. Integrating the New Thromboprophylaxis Guidelines Into Obstetric Anesthesia Practice. Survey Of Anesthesiology 2017, 61: 14. DOI: 10.1097/01.sa.0000513496.39516.43.Peer-Reviewed Original ResearchVenous thromboembolismPatient care recommendationsObstetric anesthesia practiceConsensus BundleThromboprophylaxis guidelinesVTE ratesMaternal deathsNeuraxial anesthesiaObstetric patientsObstetric anesthesiaCare recommendationsAnesthesia practiceAnesthesiaNational PartnershipRiskThromboembolismPatients
2013
Spinal Anesthesia in Severe Preeclampsia
Henke VG, Bateman BT, Leffert LR. Spinal Anesthesia in Severe Preeclampsia. Anesthesia & Analgesia 2013, 117: 686-693. PMID: 23868886, DOI: 10.1213/ane.0b013e31829eeef5.Peer-Reviewed Original ResearchConceptsSevere preeclampsiaSpinal anesthesiaIntraoperative hemodynamic managementSpinal-induced hypotensionHealthy parturientsAnesthetic optionsCesarean deliveryEpidural catheterHemodynamic managementNeuraxial anesthesiaEpidural anesthesiaHigh incidencePreeclampsiaAnesthesiaHypotensionSignificant differencesParturientsContraindicationsCatheterIncidence