Acceptable INR level for epidurals?

[Ligament]

What is your minimum acceptable INR level for epidurals?

Some go for <1.5, some 1.2 or less. I go for 1.2 or less.

ASRA guidelines do not specify a specific INR level as best I can tell.

---

Members don't see this ad.

 

[2win]

What is your minimum acceptable INR level for epidurals?

Some go for <1.5, some 1.2 or less. I go for 1.2 or less.

ASRA guidelines do not specify a specific INR level as best I can tell.

1.2 just to save my headache.

 

[PMR 4 MSK]

1.3 max

 

[lobelsteve]

1.5 acceptable, 1.2 preferred

 

[Tenesma]

depends on what i am doing - anything cervical or lumbar TFESI/IESI it has to be <1.3... the 1.5 figure came from the surgical literature and is considered acceptable - but i would argue that we don't have the luxury of coagulating or holding pressure over an oozer/bleeder- therefore i don't believe the 1.5 really is acceptable for us...

 

[drrinoo]

there is a hysteresis with respect to INR

an INR of 1.5 conveys a different level of bleeding risk depending on whether a patient is started on anticoagulation vs. coming off of anticoagulation.

1.0-->1.5

2.0--> 1.5

In these scenarios, INRs are the same (1.5) but they convey different bleeding risks

I learned this a few years ago when I was preparing a manuscript on bleeding risk in IP: http://www.painphysicianjournal.com/2004/january/2004;7;3-51.pdf

 

[Ligament]

Interesting. So when you are doing procedures on your patients, what parameters do you use for an acceptable INR?

there is a hysteresis with respect to INR

an INR of 1.5 conveys a different level of bleeding risk depending on whether a patient is started on anticoagulation vs. coming off of anticoagulation.

1.0-->1.5

2.0--> 1.5

In these scenarios, INRs are the same (1.5) but they convey different bleeding risks

I learned this a few years ago when I was preparing a manuscript on bleeding risk in IP: http://www.painphysicianjournal.com/2004/january/2004;7;3-51.pdf

http://www.painphysicianjournal.com/2004/january/2004;7;3-51.pdf

 

[Tenesma]

nicole - 1.5 is acceptable in the surgical literature because they can apply pressure or cauterize bleeding - try doing that during a TFESI...

 

[GQPMR]

depends on what i am doing - anything cervical or lumbar TFESI/IESI it has to be <1.3... the 1.5 figure came from the surgical literature and is considered acceptable.

Exact words as Tenesma earlier in this thread... She's done this on another thread as well. I believe we have a spammer here.

 

[Jeff05]

ASRA guidelines for REMOVAL is <1.5

No number for placement offered by ASRA.

Our institution uses 1.3 as a cutoff.