They have produced guidelines for neuraxial anaesthesia/analgesia adjusted for the relative risk of morbidity or mortality. For instance, if the benefit of spinal anaesthesia is to avoid mortality the platelet count should be above only 30,000 / dl and the INR below 2.2. If it is merely to make a patient more comfortable in the early postoperative period the conditions should be the more stringent (and conventional!) levels of 100, 000 /dl and 1.4.
From SSAI:
It's a practical and gutsy approach to the risk-benefit conundrum. I'm not so sure about the INR levels though and I'll look into their cited evidence. My understanding is that relative thrombocytopenia seems to be OK for spinal block but coagulation factor disturbance seems more likely to cause traumatic haematoma.
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