LUMBAR PUNCTURE-RECOMMENCE ANTICOAGULANTION

SUMMARY

1. While the optimal timing of restarting anticoagulation after LP is not known, the incidence of spinal hematoma in one series was much lower when anticoagulation was started at least 1 hour after the LP.

2. NOACs can be restarted 6-8 hours after an atraumatic spinal or epidural anaesthesia or clean LP.

3. However, in traumatic procedures with increased risk of bleeding, the guidelines recommend restarting NOACs 48-72 hours after complete haemostasis.

Reference(s)

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Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].