Epidural analgesia and drugs affecting hemostasis 2019




spinal epidural hematoma


 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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