Question

A 82-year-old female is scheduled for a total hip replacement under spinal anesthesia. She has been receiving enoxaparin for deep vein thrombosis prophylaxis. Current recommendations regarding the dosing of enoxaparin state that the drug be:

a. continued without interruption as scheduled
b. held for 4 - 6 hours prior to the spinal anesthetic
c. held for 10 - 12 hours prior to the spinal anesthetic
d. held for not less than 24 hours prior to the spinal anesthetic

Answer 1

Enoxaparin should be held for 10 - 12 hours prior to spinal anesthesia to minimize the risk of bleeding complications. This is in line with current recommendations for patients receiving anticoagulation therapy before such procedures.

Step-by-step explanation:

In the context of a patient scheduled for total hip replacement who has been receiving enoxaparin for deep vein thrombosis prophylaxis, it is generally recommended to hold the medication for a certain period before performing a spinal anesthetic. The correct action to take regarding the dosing of enoxaparin would be held for 10 - 12 hours prior to the spinal anesthetic. This precaution is taken to minimize the risk of bleeding complications associated with the anticoagulant effects of enoxaparin and the procedural risk of needle placement during spinal anesthesia. It's essential to refer to updated guidelines or hospital protocols, as recommendations might vary based on the enoxaparin dose and individual patient risk factors.