Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

Table 7

ASRA guidelines for RA in the patient receiving anticoagulation therapy.

Anticoagulation	Dosage	Recommendations
Unfractionated heparin	SC BID	No contraindications
	SC TID	No recommendations—unknown risk
	IV loading dose	Delay administration >1 hour after needle placement or catheter removal
		Remove catheter 2–4 hours after last dose
LMWH	SC daily	Needle placement or catheter removal 10–12 hours after last dose
		Delay dosing 2 hours after removal of catheter
	SC BID	Needle placement or catheter removal 24 hours after last dose
		Delay dosing 2 hours after removal of catheter
Warfarin		Stop 4-5 days prior to neuraxial technique, INR < 1.5 prior to needle placement or catheter removal
NSAID		No contraindications
GPIIB/IIIA antagonists
Ticlopidine		Delay 14 days
Clopidogrel		Delay 7 days
Herbal therapy		No contraindications when used independently