Lovenox injection within 24 hours of spinal

[lance]

Does anyone know how many hours preceding a spinal/epidural sub cutaneous heparin (lovenox) should be discontinued?

I have been given conflicting instructions 1. "we prefer to withhold low molecular wt heparin (lwmh) ie lovenox 24 hours before, in your case with a mechanical valve that is not safe which is why the IV heparin is indicated." This method requires an extra night in the hospital (IV drip).

That was last week. This week:

2. The day preceding surgery I'm only supposed to take lovenox (80mg) in the a.m. not the evening meaning it's only 1/2 the dose.

OK my understanding is that is still within the 24 hr of surgery and could result in paralysis.

These people are supposed to know what they are doing.

Can anyone add anything. My family wonder why I hate warfarin.

Strokes, heart attack, bleeding, scarred veins, paralysis the list seems endless.

Maybe I should resign myself to living the rest of my life with the condition that requires surgery. This is a nightmare.

Sorry for venting but this is how I feel. I usually don't post anything when I'm this depressed.

 

[Nancy]

This is the link that I found, see the red box.

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601210.html

Your doctor should know the time frame, with bloodwork. It really, really is his job to take care of things correctly. That's why he gets paid the big bucks. It is SO dangerous and annoying when it doesn't happen.

I am so sorry you have this added stress.

 

[lance]

Medline Plus Black Box Warning

Medline Plus Black Box Warning

Hi Nancy,

I have carefully read the warning you refer to and it doesn't mention a withdrawal period prior to a spinal.

The anticoagulation clinic is contradicting itself and I don't know what to believe.

 

[BAV Pt's daughter]

Lovenox

Lovenox

I work on a medical floor and have never been ordered to withhold Lovenox (which we use VERY regularly) for a spinal tap. We do not usually have a lot of bleeding associated with this procedure. You should check with the actual physician who will be performing the procedure to be safe, though. Maybe your pharmacist could give you some insight as well. Good luck.

 

[Guest]

One problem with Lovenox is that very few medical centers can do the anti Xa (10a) test that measures the level of Lovenox activity within 24 hours. So the test is usually meaningless by the time the results are back. I would think that it would be a 24 hour hold on Lovenox before an epidural - probably even a spinal, too. We don't get a lot of blood only refers to the outside that you can see. All it takes is about a drop to go into the spine to cause paralysis. There is no way for the blood to get back out. Doing a spinal with someone on Lovenox is probably Russian roulette.

 

[lance]

24-hour hold on lovenox

24-hour hold on lovenox

One problem with Lovenox is that very few medical centers can do the anti Xa (10a) test that measures the level of Lovenox activity within 24 hours. So the test is usually meaningless by the time the results are back. I would think that it would be a 24 hour hold on Lovenox before an epidural - probably even a spinal, too. We don't get a lot of blood only refers to the outside that you can see. All it takes is about a drop to go into the spine to cause paralysis. There is no way for the blood to get back out. Doing a spinal with someone on Lovenox is probably Russian roulette.

Thanks for responding, Al

My understanding of a 24-hour hold is just that--no lovenox the a.m. prior to surgery even though it should be cleared in 12 hours.