Is there haemostatic interaction between low-molecular-weight heparin and non-steroidal analgesics after total hip replacement?

Epidural anaesthesia and spinal haematoma

“…A combination of NSAID with epidural anaesthesia, frequently found in clinical practice, was associated with haematomas in three cases probably indicating no increased risk. This conclusion is in accordance with an analysis performed by Horlocker et al and Weale et al, 63,64 who found no correlation between antiplatelet therapy and bloody needle or catheter placement.…”

“…Less information exists relating to the incidence of these complications following treatment with the newer, low molecular weight heparins 41,62,63,88,96 but since the risk of other (surgical) bleeding complications such as wound haematoma is not increased in comparison with the use of unfractionated heparin, 97 it is unlikely that low molecular weight heparins present a special risk. It can be concluded from this analysis of case reports, that the combination of low dose heparin or NSAID with epidural anaesthesia is safe clinical practice.…”

Safety of Peri-Operative Low-Dose Aspirin as a Part of Multimodal Venous Thromboembolic Prophylaxis for Total Knee and Hip Arthoplasty

“…3,5,6 Aspirin has been reported to reduce the frequency of venous thrombosis, pulmonary embolism, and occlusive arterial events. [7][8][9] Its cessation before surgery has been thought to increase the risk of acute cardiovascular syndromes.…”

“…Infection, bleeding, bruising, haematoma, prolonged wound drainage, and other wound complications were measured using the subjective rating scale (Table 1). 3 The differences between groups were compared using the Student's t test. Safety of peri-operative low-dose aspirin 343…”

Thromboembolism and thromboprophylaxis in high risk surgery: facts and assumptions - a topic for emotions?

“…In an abstracted North American study, comparing LMWH administered at the time of the surgical procedure with postoperative LMWH, a nonsignificant, slightly increased bleeding tendency was found in the first group [37]. In a prospective controlled trial, perioperative administration of NSAIDs together with LMWH were found not to increase bleeding when compared to LMWH alone [44].…”