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Systemic Heparinization After Neuraxial Anesthesia in Vascular Surgery: A Retrospective Analysis.

Dana Archibald¹, Thomas Stambulic², Morgan King²

¹Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.

Journal of Cardiothoracic and Vascular Anesthesia

|January 7, 2023

Summary

Most vascular surgery patients received systemic heparinization within 1 hour of neuraxial anesthesia (NA), aligning with guidelines to prevent spinal hematoma (SH). No SHs occurred in this study, suggesting current practices may be safe.

Keywords:

neuraxial anesthesia retrospective analysis spinal hematoma systemic heparin vascular surgery

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Area of Science:

Anesthesiology
Vascular Surgery
Pain Medicine

Background:

Current guidelines recommend a 1-hour interval between neuraxial anesthesia (NA) and systemic heparinization to minimize spinal hematoma (SH) risk.
The safety and adherence to this interval in vascular surgery patients require characterization.

Purpose of the Study:

To determine the time interval between NA and systemic heparinization in vascular surgery patients.
To assess the incidence of SH and estimate the risk of SH formation.

Main Methods:

Retrospective analysis of 127 vascular surgery patients who received NA between April 2012 and April 2022.
Data collected included time from NA to heparin, heparin dose, surgery length, NA difficulty, and patient demographics.

Main Results:

The average time from NA to heparin administration was 42.8 ± 22.1 minutes.
83.7% of patients received heparin within 1 hour of NA.
No spinal hematomas were reported during the study period.

Conclusions:

The majority of vascular surgery patients in this academic center received heparin within the recommended 1-hour interval after NA.
Further research is needed to validate these findings in diverse settings.