subcutaneous heparin and spinals

OneFellSwoop

Full Member
10+ Year Member
Sep 8, 2008
95
123
266
  1. 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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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
15+ Year Member
Jan 19, 2005
2,293
1,364
316
39
Nowhere, nowhere at all...
  1. 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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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

Sent from my SM-G930V using Tapatalk
 

drmwvr

Full Member
10+ Year Member
Dec 2, 2008
820
520
266
  1. 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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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.
 
About the Ads
This thread is more than 4 years old.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.