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subcutaneous heparin and spinals

OneFellSwoop

Full Member
10+ Year Member
Sep 8, 2008
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  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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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
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    Jan 19, 2005
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    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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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

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      Dec 2, 2008
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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 I was looking at the ASRA coag app and there seems to be a new unpublished recommendation to hold heparin for 4h and ideally 6 prior to placement.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!

        No more concern than with aspirin.
         
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