What is the protocol for restarting UFH after neuraxial blockage and catheter removal?

The protocol for restarting unfractionated heparin (UFH) after the removal of neuraxial blockade or catheter is to wait a specific duration to minimize the risk of hematoma formation at the site of the catheter insertion. The recommended practice is to resume UFH treatment one hour after the removal of the neuraxial catheter or after the complete resolution of the anesthesia effects.

This cautious approach ensures that any residual effects of the anesthetic have dissipated, reducing the potential for complications such as bleeding. Immediate resumption could expose the patient to greater risk without allowing for adequate recovery time from the effects of the anesthesia. Similarly, longer delays, such as 6 hours or 24 hours, may unnecessarily prolong anticoagulation management, which could be detrimental to the patient’s treatment plan if UFH is necessary for managing thromboembolic risks. Thus, waiting one hour strikes a balance between safety and timely recommencement of anticoagulation therapy.