What are risk factors for deep venous thrombosis (DVT) prophylaxis in patients undergoing spinal or epidural anesthesia?

Updated: Jul 25, 2019
  • Author: David A Forsh, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Answer

Anticoagulant prophylaxis should be used with caution in patients receiving spinal or indwelling catheter epidural anesthesia. Although the risk of spinal hematoma is very small (0.0025% with spinal anesthesia and 0.03% with epidural anesthesia), care should be taken to delay the initiation of thromboprophylaxis for at least 2 hours after catheter removal. Patients with known bleeding disorders should not receive preoperative prophylaxis if they are to receive spinal anesthesia. In cases of traumatic spinal tap with bloody spinal fluid, postoperative administration of thromboprophylaxis should be done with caution.


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