Open AccessSafe removal of an epidural catheter 72 hours after clopidogrel and aspirin administrations guided by platelet function analysis and thromboelastography
Author(s) -
Eric Glenn,
Judson Mehl,
Francis Rosinia,
Henry Liu
Publication year - 2013
Publication title -
journal of anaesthesiology-clinical pharmacology/journal of anaesthesiology clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.466
H-Index - 32
eISSN - 2231-2730
pISSN - 0970-9185
DOI - 10.4103/0970-9185.105813
Subject(s) - medicine , clopidogrel , thromboelastography , aspirin , anesthesia , catheter , neuraxial blockade , thromboelastometry , anesthesiology , platelet , surgery , spinal anesthesia
Management of neuraxial anesthesia/analgesia in anticoagulated patient can be challenging. The shortest safe time to remove epidural catheter, after a patient receives long-acting dual antiplatelet agents (clopidogrel and aspirin), is unclear. American Society of Regional Anesthesiology (ASRA) guidelines recommend seven days interval for the epidural placement after clopidogrel administration. However ASRA Guideline did not specify the time for epidural catheter removal, and did not specify how much time elapse necessary after dual antiplatelet therapy with clopidogrel and aspirin. We report a case of safe removal of epidural catheter 72 hours after oral dose of clopidogrel and aspirin with a normal platelet function analysis and normal thromboelastography before removal.