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My practice has been to essentially ignore prophylactic heparin 5k U bid when performing neuraxial blocks. I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement. in the 2010 ASRA guidelines there's a vague reference to delaying the injection until after the block as this "may" reduce the bleeding risk, however they state there's really no contraindication. Most academic recommendations I find essentially recommend the same thing as my current practice.
Anyone have any thoughts on this? Thanks in advance!
Anyone have any thoughts on this? Thanks in advance!