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If bloody tap during spinal or epidural, ideally postpone 24hrs. Discuss risk vs benefits of delaying case with the surgeon.

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Intravenous heparin bolus will need to be given ~3min prior to arterial clamping

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All recommendations on anticoagulation and regional in vascular surgery originally from Rao TL, El-etr AA. Anesthesiology 1981 55:139-146

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Wait one hour after neuraxial procedure before administering heparin during case.

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Combined spinal epidural anesthesia for cases that may be prolonged by conversion to arterial bypass graft surgery

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Be aware of reperfusion hypotension on removal of cross clamp from aorta or femoral artery.

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Spinal anesthesia

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Surgeon may ask for heparin infusion. Consider timing of removal when an epidural has been placed

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