Therapeutic LMWH Neuraxial Interval — FRCA Final MCQ

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ModerateRegional AnaesthesiaTherapeutic LMWH Neuraxial IntervalFRCA Final

A 55-year-old man requires a lumbar puncture. He is on therapeutic-dose enoxaparin 1.5 mg/kg daily. The minimum interval from last enoxaparin dose to LP is:

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Correct answer: C — 24 hours

For therapeutic-dose LMWH (e.g., enoxaparin 1.5 mg/kg), the minimum interval before neuraxial/LP is 24 hours (Association of Anaesthetists 2013, ESRA 2022). For prophylactic-dose LMWH (e.g., enoxaparin 40 mg), the interval is 12 hours. Anti-Xa level can be checked if timing is uncertain (should be <0.1 IU/mL for neuraxial).

Reference: Association of Anaesthetists – 2013 – Regional anaesthesia and coagulation; ESA – 2022