Anticoagulant Drugs: What to Know Before Surgery
Anticoagulant Drugs: What to Know Before Surgery
Why It Matters
Anticoagulant drugs are powerful tools in preventing clots, but they need careful management around surgery to avoid bleeding.
Contents
- The Role of Anticoagulants
- Types of Anticoagulants
- Managing Anticoagulants Before Surgery
- Post-Surgery Anticoagulant Resumption
The Role of Anticoagulants
Anticoagulants are medications that help prevent blood clots. They are essential for patients with conditions like atrial fibrillation or those who have had previous clots. However, during surgery, these drugs can increase bleeding risk, so doctors may adjust or pause them temporarily.
Types of Anticoagulants
Common anticoagulants include warfarin, heparins, and direct oral anticoagulants like apixaban. Warfarin takes longer to wear off and requires careful planning around surgery. In contrast, direct oral anticoagulants have a quicker onset and wear-off period, making them easier to manage for surgical patients.
Managing Anticoagulants Before Surgery
Before surgery, doctors assess the bleeding risk and decide on anticoagulant management. Warfarin might be stopped several days ahead, while direct oral anticoagulants like apixaban may be paused for just a day or two. This timing helps minimize bleeding risk while maintaining protection against clots.
Post-Surgery Anticoagulant Resumption
After surgery, anticoagulants are resumed when it's safe to do so, usually within a day or two. This helps prevent clot formation as the body heals. The timing depends on the procedure type and how the patient recovers from surgery.
FAQs
What are anticoagulants?
They are drugs that prevent blood clots.
Why adjust anticoagulants before surgery?
To reduce the risk of bleeding during surgery.
How long before surgery should warfarin be stopped?
Usually about five days before surgery.
When can anticoagulants be resumed after surgery?
Typically within one or two days post-surgery.
What are direct oral anticoagulants?
They are newer anticoagulants with a rapid onset and offset.
The Bottom Line
Managing anticoagulants around surgery is crucial for patient safety and requires careful planning.
Additional References
- Douketis JD, Spyropoulos AC, Murad MH, et al. Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline. Chest 2022; 162:e207.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.