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)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
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].