Pain Research and Treatment / 2014 / Article / Tab 7

Review Article

Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

Table 7

ASRA guidelines for RA in the patient receiving anticoagulation therapy.

Anticoagulation DosageRecommendations

Unfractionated heparinSC BIDNo contraindications
SC TIDNo recommendations—unknown risk
IV loading doseDelay administration >1 hour after needle placement or catheter removal
Remove catheter 2–4 hours after last dose
LMWHSC dailyNeedle placement or catheter removal 10–12 hours after last dose
Delay dosing 2 hours after removal of catheter
SC BIDNeedle placement or catheter removal 24 hours after last dose
Delay dosing 2 hours after removal of catheter
WarfarinStop 4-5 days prior to neuraxial technique, INR < 1.5 prior to needle placement or catheter removal
NSAIDNo contraindications

GPIIB/IIIA antagonists
TiclopidineDelay 14 days
ClopidogrelDelay 7 days
Herbal therapyNo contraindications when used independently

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