Regional anaesthesia and patients with abnormalities of coagulation

Regional anaesthesia and patients with abnormalities of coagulation

Please note that these guidelines are currently under review and will be updated in due course


Anaesthetists often face the question of whether the risks of regional anaesthetic techniques are increased when performed on patients with abnormalities of coagulation, and, if so, whether they are so increased that the techniques should be modified or avoided. 

These guidelines relate to abnormalities of coagulation, whether the result of the administration of drugs, or that of pathological processes, to the consequent haemorrhagic risks associated with neuraxial and peripheral nerve blocks. 

These guidelines contain four tables that address risks associated with:

  • Anticoagulant drugs
  • Neuraxial and peripheral nerve blocks
  • Obstetric anaesthesia
  • Special circumstances such as trauma, sepsis and massive transfusion

In the guideline the notes to accompany Table 2 stated that there was one death in a patient who underwent lumbar plexus block. This was incorrect, and should read:

“The one death in this series was that of a patient on clopidogrel who underwent a lumbar sympathetic block...”