Intercostal blocks and anticoagulation

[Jcm800]

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Anyone have a reference specifically citing intercostal blocks and anti-coagulation, specifically Plavix. I have never held anticoagulation for and intercostal block however a colleague and I were having a discussion and evidently the new ASRA guidelines define it as a “deep nerve block” and therefore it falls under the category of relative contraindication and he recommends holding anticoagulation. Thoughts?

 

[lobelsteve]

Asra are killers in their guidelines. Many have and will die or have MI/CVA because of these guidelines. Use SIS or other. Or dont offer block. If event occurs, the doc asking permission and the doc granting it both get named.

 

[blockstar]

Just was on call this past weekend in patient who had lami done for epidural hematoma after patient received an epidural five days after stopping xarelto.

 

[soccrwz]

Try omgui technique less risk of bleeding since your not near any vessels

 

[10KHertz]

Just was on call this past weekend in patient who had lami done for epidural hematoma after patient received an epidural five days after stopping xarelto.

I have seen this after ESIs and a paddle placement as well. The patients’ had stealth Von Willebrands disorder.

 

[lobelsteve]

Just was on call this past weekend in patient who had lami done for epidural hematoma after patient received an epidural five days after stopping xarelto.

If 5 days then not Xarelto, just bad luck.

 

[clubdeac]

Just was on call this past weekend in patient who had lami done for epidural hematoma after patient received an epidural five days after stopping xarelto.

You know if it was an interlaminar or TFESI

 

[blockstar]

You know if it was an interlaminar or TFESI

not sure i think interlaminar