Anaes · Patient safety
Venous thromboembolism prophylaxis
Also known as VTE prophylaxis · Thromboprophylaxis · DVT prophylaxis · ASRA timing · Neuraxial anticoagulation · LMWH epidural
Exam-exhaustive perioperative VTE prophylaxis: risk stratification, mechanical and pharmacological options, extended prophylaxis after major ortho/cancer surgery, and ASRA timing principles with neuraxial anaesthesia and catheter removal for ANZCA Final and equivalents.
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8 MCQs with explanations
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Meet the patient
A 72-year-old woman for a total hip replacement is on evening enoxaparin 40 mg for VTE prophylaxis, and the surgeon has requested a spinal for analgesia. The question that decides her night is the ASRA window: is twelve hours enough, and when does the next dose go in after the catheter comes out?[1]
Two ideas frame every VTE decision: the bleeding risk and the clot risk are weighed against each other, never in isolation, and the neuraxial needle and the epidural catheter are as dangerous as any anticoagulant — both insertion and removal are high-risk moments. Hold those two and the protocol reads itself.[1]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Anaesthesia fellowship atlas.
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- [1]Kopp SL, Vandermeulen E, McBane RD, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (fifth edition) Reg Anesth Pain Med, 2025.PMID 39880411
- [2]Lohr J, et al. Evolution of the Caprini risk assessment score: 1991 to present: A living risk assessment tool J Vasc Surg Venous Lymphat Disord, 2026.PMID 42331469
- [3]Choi JDW, et al. The efficacy and safety of extended thromboprophylaxis after colorectal surgery: a systematic review and meta-analysis Int J Colorectal Dis, 2025.PMID 41065855
- [4]Riediger C, et al. Aspirin for Venous Thromboembolism Prevention in Orthopaedic Surgery with Focus on Trauma and Arthroplasty: A Structured Evidence-Based Review of Randomised Trials, Guidelines, and Contemporary Practice Considerations J Clin Med, 2026.PMID 42355718