Cardiothoracic & vascular anesthesia
Systemic Heparinization After Neuraxial Anesthesia in Vascular Surgery: A Multicenter Retrospective Analysis
Authors' conclusion
Despite significant variability among participating institutions, anesthesiologists at all centers often overlooked societal guidelines and administered systemic heparin before the 1-hour recommendation following NA. Guideline compliance also varied across the surgical procedures studied. No cases of SH were reported.
Study context
- Population
- Adult vascular surgery patients undergoing femoral-femoral bypass, femoral-tibial bypass or endovascular aneurysm repair under neuraxial anaesthesia with subsequent systemic heparinization, Canadian academic tertiary centres, April 2012–April 2023analysed
- Participants
- 877 patients
- Outcome
- IV heparin given before the recommended interval after neuraxial anaesthesia
Methodological detailsmulticentre, retrospective chart review
- Multicentre
- Retrospective chart review
Main finding
As reported in the abstract
IV heparin <60 minutes after neuraxial anaesthesia
41.2%
IV heparin <45 minutes after neuraxial anaesthesia
26.3%
Observational data: associations, not effects.
Secondary outcomes
Guideline compliance, endovascular aneurysm repair (subgroup)
- Heparin <60 minutes after neuraxial anaesthesia (shortest interval at all centres)
- 63.3%
- Heparin <45 minutes after neuraxial anaesthesia
- 41.2%
Safety
- Cases of clinically significant spinal hematoma
- 0
- Estimated risk, frequentist, 95% confidence
- ≤0.8%
- Estimated risk, frequentist, 99% confidence
- ≤1.3%
- Estimated risk, Bayesian, 95% credibility
- ≤0.3%
- Estimated risk, Bayesian, 99% credibility
- ≤0.34%
- Secondary outcome
- Zero numerator
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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