Epidural analgesia and drugs affecting hemostasis 2019
The current recommendations of when anticoagulants should be stopped prior to
neuroaxial blockade are shown below. Blood results, specifically full blood count and coagulation screen should be reviewed as well as markers of infection. In certain patients, such as those with previous spinal surgery or scoliosis, reviews of spine X-rays or CT scans may be necessary.
Drug
|
When to stop
|
Aspirin
|
Continue
|
NSAID
|
Continue
|
Heparin
|
Stop before 4 h
|
LMWH
|
Stop before 12 h (prophylactic dose)
Stop before 24 h (treatment dose)
|
Warfarin
|
Stop before 5 days (INR to be below
1.5)
|
Clopidogrel
|
Stop before 1 week (range 5–10 days)
|
Teicoplidine
|
Stop before 2 weeks
|
GIIa/III
|
Stop before 4 weeks
|
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