ezemljakMemberMarch 27, 2011 at 10:36 amPost count: 2
Is it possible to donate blood for surgery if you are on coumadin? What is the process to prepare for surgery if you are on coumadin because of a history of blood clots? Thank youDonald Corenman, MD, DCModeratorMarch 27, 2011 at 12:29 pmPost count: 8427
Surgery when on Coumadin is not advisable unless an emergency. As you already know, Coumadin (Warfarin) interferes with the clotting cascade. This cascade is important to prevent bleeding with injury or if a stomach ulcer exists. Patients on Coumadin most likely have a clotting disorder or have had a previous condition like atrial fibrillation or prior blood clots.
For patients undergoing elective surgery, the normal procedure is to stop Coumadin for about 2-3 days before surgery and start Lovenox- an injectable anticoagulant that has immediate onset and lasts 12 hours. This is then used for 2-3 days until the Coumadin has worn off and then the Lovenox is discontinued. 12 hours after being discontinued, surgery is performed. For spine surgery, normally Lovenox is started 24-36 hours after surgery. There is still a risk of bleeding at the surgery site.
Donating blood prior to surgery while on Coumadin is not generally recommended unless a serious reason is present for the need for blood.ezemljakMemberMarch 27, 2011 at 11:18 pmPost count: 2
Thank you for the response. Can a discogram be performed while on Coumadin?Donald Corenman, MD, DCModeratorMarch 27, 2011 at 11:45 pmPost count: 8427
Any spinal injection should not be performed with anticoagulation. The risk of bleeding in the canal is increased which can cause significant pressure and possible nerve injury. Discograms are included in the list of spinal injections.
Dr. Corenmanatierney77MemberJune 27, 2012 at 7:51 amPost count: 3
Hi. I wanted to ask what you would do if there is a fracture to the C2 and the person is on coumadin. Would you stop it all together or would you use Lovenox? What is the short term way to address this?Donald Corenman, MD, DCModeratorJune 28, 2012 at 1:50 amPost count: 8427
If the patient is on anti-coagulation with some exceptions, the anti-coagulation should be stopped prior to surgery. Normally if the patient is on Coumadin, the Coumadin is stopped 3-4 days prior to surgery and the patient is placed on Lovenox. The Lovenox is stopped 12-24 hours prior to spine surgery and started 24-48 hours after surgery.
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