Rethinking DOACs for Neuraxial & Deep Blocks

This episode discusses the main findings from a 2025 review by Suleiman et al. published in BJA, examining how we should manage direct oral anticoagulants (DOACs) in patients having neuraxial anesthesia and deep peripheral nerve blocks. Traditionally, the ASRA guidelines have leaned heavily on long DOAC interruption times and selective drug level testing to avoid the rare but devastating complication of spinal epidural hematoma. But new evidence—from the PAUSE strategy and the PAUSE-2 pilot trial—suggests that shorter, pharmacokinetics-based DOAC holds may offer comparable safety without increasing thromboembolic risk.Where else to find us: Web- ⁠⁠http://www.nysora.com⁠⁠ Instagram- ⁠⁠instagram.com/nysora.inc/ ⁠⁠LinkedIN- ⁠⁠linkedin.com/company/nysora-inc/⁠⁠ Facebook- ⁠⁠facebook.com/nysora⁠⁠ Twitter- ⁠⁠x.com/nysora⁠⁠ TikTok- ⁠⁠tiktok.com/@nysora_inc⁠⁠ --------------------------------------------------------- ⁠⁠#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

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