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Central nerve block and coagulation: a survey of obstetric anaesthetists
1Department of Anaesthetics, Birmingham Women's Hospital, UK. liang.wee@uhl.nhs.uk
We conducted a survey amongst anaesthetists in 264 obstetric units in the UK to examine their practice in relation to potential clotting abnormalities. The survey was conducted between July and November 1998 and shows a varied opinion and practice. We received a return of 226 (86%) with 64-78% of respondents willing to perform a central nerve block at a platelet count of 80 x 10(9)/L or more. Patients on aspirin alone or aspirin and heparin would be given a central nerve block by up to 96% and 43% of respondents respectively. Following administration of heparin, up to 22% of respondents would perform a central nerve block within 2 h while up to 64% would wait beyond 4 h. Eighty-five units had departmental policies on the removal of epidural catheters but only 15 differentiated between unfractionated and low molecular weight heparin.
We conducted a survey amongst anaesthetists in 264 obstetric units in the UK to examine their practice in relation to potential clotting abnormalities. The survey was conducted between July and November 1998 and shows a varied opinion and practice. We received a return of 226 (86%) with 64-78% of respondents willing to perform a central nerve block at a platelet count of 80 x 10(9)/L or more. Patients on aspirin alone or aspirin and heparin would be given a central nerve block by up to 96% and 43% of respondents respectively. Following administration of heparin, up to 22% of respondents would perform a central nerve block within 2 h while up to 64% would wait beyond 4 h. Eighty-five units had departmental policies on the removal of epidural catheters but only 15 differentiated between unfractionated and low molecular weight heparin.
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