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Interventional pain management bears a significant risk of hemorrhagic complications. This risk increases in patientswith coagulation disorders and those taking anticoagulant therapy. The population of the latter is growing, and manynew drugs and new treatment regimens have become widespread in recent years. The latest guidelines on the periproceduraluse of anticoagulant therapy also apply to regional anaesthesia techniques for the treatment of chronicand acute pain. However, despite the existence of guidelines and recommendations, decision-making difficultiescan still be encountered in the practice of interventional pain management. The presentation includes a summaryof existing recommendations for the prophylactic use of anticoagulants and antiaggregants in clinical practice inthe periprocedural period. Also included is a discussion of selected concerns regarding their use in the practice ofinterventional pain management.

Peripheral intravenous catheters (PIVCs) play a particularly important role in Emergency Departments (ED), during the administration of anesthesia in the operating room, in post-operative and monitored wards of various specialties, in cases when the patient requires access to the vein due to intensive and varied intravenous therapy. Using short peripheral intravenous catheters carries a high risk of complications, despite their prevalence and staff experience. Patients with DIVA require a comprehensive approach not only during elective (scheduled) intravenous therapy, but also in the aforementioned departments and during emergency interventions in case of deterioration in Non-Intensive-Care-Units. Emergency intravenous access is required for the implementation of many procedures, so it is reasonable to introduce methods that increase the safety and quality of therapy. Midline catheters (MCs) are becoming increas¬ingly popular in Poland. However, based on our experience, they are not the optimal solution in every situation. “Mini-midlines” can be clinically useful in patients with DIVA whose therapy is expected to exceed 5 days. They may be applied in patients who require a secure and rapid insertion of the cannula into the vein and greater fluid flow than via a classic MC. Regardless of the equipment used, the ultrasound-guided mini-midline implantation procedure is simple and quick. Based on available research and experience at our centres, we follow a management regimen for patients who arrive in the ED, have no intravenous access and the team is faced with the clinical dilemma of choosing which cannulation method should be used. Proper patient enrollment and subsequent cannula maintenance increases the quality of care and patient satisfaction. It is advisable to introduce local protocols for selecting appropriate intravenous access and to run prospective studies regarding the topic under discussion.