Anaes SAQs · Neuraxial anaesthesia
The anticoagulated patient and the neuraxial technique — ASRA guidelines
The ASRA anticoagulation SAQ — the timing of the neuraxial needle and catheter relative to LMWH (12-24h), warfarin (INR under 1.4), clopidogrel (7 days), and the DOACs (2-5 days). The principle: do not place or remove while the anticoagulant effect is present.
On this page
Study tools
Target exams
ANZCAFRCAABAEDAIC
Prompt
Outline the ASRA guidelines on the timing of neuraxial techniques in patients receiving antithrombotic therapy. Include the specific timing for LMWH, warfarin, clopidogrel and the direct oral anticoagulants.
Question
Outline the ASRA guidelines on the timing of neuraxial techniques in patients receiving antithrombotic therapy. Include the specific timing for LMWH, warfarin, clopidogrel and the direct oral anticoagulants.
[2]References2ShowHide
- [2]Horlocker TT, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Regional Anesthesia and Pain Medicine, 2010.PMID 20052816
- [3]Narouze S, et al. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition): Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain. Regional Anesthesia and Pain Medicine, 2018.PMID 29278603