by Doaa Kamal
Regional Anesthesia & Anticoagulation
Drug Name
Stopped before RA
Restarted after RA
Control test
Reversed by
Warfarin (Marevan)
3 days (at least)
(PT) INR ≤ 1.4
Vitamin K, FFP
Heparin:
Prophylactic: 5000 IU/8 hr SC
Therapeutic: 5000 IU/4 hr IV
Not stopped
6 hours
PTT
FFP, protamine
LMWH:
Prophylactic: 0.5 mg/kg/24 hr
Therapeutic: 1 mg/kg/12 hr
12 hours
24 hours
2 hours
2 hours (postpone 24 hr if
bloody tap)
F Xa (activated F 10)
FFP
Streptokinase (thrombolytic)
ABSOLUTE
CONTRAINDICATION
Wait at least 10 days
Antiplatelets:
Aspirin (Aspocid)
Not stopped
Bleeding time
Ticlopidine (Ticlid)
14 days (2 wks)
Bleeding time
1 hour
(Not available)
Platelet transfusion
Methylprednisolone 20 mg IV
Clopidogrel (Plavix, Stroka, Clopex)
7 days (1 week)
Tirofiban (Aggrastat)
8 hours
Abciximab (monoclonal antibodies)
2 days
Pletaal (Cilostazol)
Trental (Pentoxiphylline)
Bleeding time
Platelet transfusion
28 days
Bleeding time
Platelet transfusion
28 days
Bleeding time
Not reversed by platelet
transfusion.
2 days
Bleeding time
Platelet transfusion
2 days
Bleeding time
Platelet transfusion