According to a study, researchers determined that in the perioperative period, post-pubertal adolescents should be assessed for venous thromboembolism (VTE) prophylaxis because of their slightly elevated risk. The study was published online in Pediatric Anesthesia.

Regional Anesthesia

Researchers reviewed the literature to provide guidance relating to the care of children in the perioperative period. The authors reviewed the incidence of perioperative VTE, risk factors, evidence for mechanical and chemical prophylaxis, and complications and detailed safe practice of regional anesthesia with anticoagulant prophylaxis.

Areas reviewed include the incidence of perioperative venous thromboembolism (VTE), risk factors, evidence for mechanical and chemical prophylaxis, and complications. Safe practice of regional anesthesia with anticoagulant prophylaxis is detailed. In summary, there are few areas of strong evidence.

Routine prophylaxis cannot be recommended for young children. Postpubertal adolescents (approximately 13 years and over) are at a slightly increased risk of VTE and should be assessed for prophylaxis and may warrant intervention if other risk factors are present. However, the incidence of VTE is significantly lower than in the adult population.

This special interest review presents a summary and discussion of the key recommendations, a decision?making algorithm and a risk assessment chart. The authors note that few areas of strong evidence were found. For young children, the risk of VTE seemed negligible, and consequently, routine prophylaxis cannot be recommended.


Post-pubertal adolescents (about 13 years of age and older) have a slightly elevated VTE risk, although the incidence is significantly lower than that in the adult population. These adolescents should be evaluated for prophylaxis; if other risk factors are present, intervention may be warranted.

Although the evidence base for the current practice of perioperative thromboprophylaxis in children is of low quality, we think it has been possible to bring together useful information to guide safe practice.

They hope the decision-making algorithm and risk assessment form will be of practical use and the key recommendations will help improve the perioperative care of children.