subcutaneous heparin and spinals

[OneFellSwoop]

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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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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!

 

[psychbender]

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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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]

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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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.

 

[polar403]

It's a draft recommendation. It hasn't been set in stone.

http://www.anesthesiologynews.com/C...-Subcutaneous-Heparin/38971/ses=ogst?enl=true


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