Regional anaesthesia: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Regional anaesthesia

Sample item

A patient on prophylactic-dose low molecular weight heparin has been planned for spinal anaesthesia. What is the minimum recommended interval between the last prophylactic dose and the neuraxial puncture?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. 12 hours

Neuraxial anaesthesia in anticoagulated patients risks epidural or spinal haematoma and cord compression. After a prophylactic dose of LMWH, at least 12 hours should pass before needle placement, and about 24 hours after a therapeutic dose. The next dose is delayed for at least 4 hours after catheter removal.

Option by option

  • A. 48 hours

    Forty-eight hours is longer than needed for a prophylactic dose.

  • B. 1 hour

    One hour is too short to allow anti-Xa activity to fall.

  • C. 12 hours (correct)

    Correct. A 12-hour gap after a prophylactic LMWH dose is the standard guidance.

  • D. 4 hours

    Four hours applies to the delay before the next dose after catheter removal, not before puncture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, 12 hours. Neuraxial anaesthesia in anticoagulated patients risks epidural or spinal haematoma and cord compression.

Why is "48 hours" not the answer?

Forty-eight hours is longer than needed for a prophylactic dose.

Why is "1 hour" not the answer?

One hour is too short to allow anti-Xa activity to fall.

Why is "4 hours" not the answer?

Four hours applies to the delay before the next dose after catheter removal, not before puncture.

What concept does this question test?

It tests Regional anaesthesia in Anaesthesia. After a prophylactic dose of LMWH, at least 12 hours should pass before needle placement, and about 24 hours after a therapeutic dose. The next dose is delayed for at least 4 hours after catheter removal.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Regional anaesthesia?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.