OneFellSwoop

10+ Year Member
Sep 8, 2008
68
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Status
Attending Physician
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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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!
 

psychbender

Cynical Member
Lifetime Donor
15+ Year Member
Jan 19, 2005
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Nowhere, nowhere at all...
Status
Attending Physician
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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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!
I don't particularly care about 5000 SQ heparin, and neither do the folk at U Washington. View attachment Neuraxial Guidelines_1.pdf

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drmwvr

10+ Year Member
Dec 2, 2008
731
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Non-Student
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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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!
No more concern than with aspirin.
 
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