To Hold or Not to Hold, That is the Question: Antiplatelet and Anticoagulation Management for Interventional Spine and Pain Procedures

Author: Abigail T. Brooks

Interventional spine and pain procedures continue to play an important role in the management of chronic pain for many patients. Pain procedures can result in improved function and better quality of life for patients, as well as pain medication sparing effects. With the aging American population and increasing polypharmacy, it is vital that clinicians working in an interventional pain procedure environment have an understanding of the complexity associated with antiplatelet and anticoagulant therapies, namely, which medications need to be held prior to a pain procedure and for how long? If anticoagulation is held, is bridging required? When should the patient resume therapy? All of these questions and more will be addressed in this presentation with a detailed review of the 2015 ASRA (American Society of Regional Anesthesia and Pain Medicine) guideline recommendations for anticoagulation and antiplatelet therapy in this unique patient population.

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