[Spinal anesthesia and prevention of thrombosis by heparin]

Non traumatic spinal hematomas are a rare pathology, anticoagulant treatments are one of their most frequent etiology. Therefore, the association of spinal anesthesia and a preventive treatment which has antithrombotic aim by the use of subcutaneous heparin (non fragmented or low molecular weight) is being discussed by many authors. It is lawful to associate spinal anesthesia with a soft dose of non fragmented subcutaneous heparin (Kakkar method) if the protocols are strictly respected. It is certainly possible to use low molecular weight subcutaneous heparin as well. However a slight decline in their use urges anyone to be very cautious.