title: Use of thromboelastography to demonstrate persistent anticoagulation after stopping enoxaparin.
abstract: Peri-operative guidelines exist for neuraxial anaesthesia and anticoagulant therapy. We describe the use of thromboelastography to assess the coagulation status of a patient with moderate renal impairment who had been receiving enoxaparin and was being managed in accordance with current recommendations. This report demonstrates that current guidelines for discontinuing treatment with enoxaparin may not allow a sufficient safety margin in all patient groups and that thromboelastography is a useful tool in such situations.
authors.affiliation: Royal Free Hampstead NHS Trust, London, UK. bekasimons@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Simons
authors.forename: S V
authors.initials: SV
authors.lastname: Mallett
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects*; D000075202:Contraindications; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods*; D051437:Renal Insufficiency / Q000378:metabolism; D013916:Thrombelastography
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin