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Perioperative Considerations in the Management of Anticoagulation Therapy for Patients Undergoing Surgery

  • Other Pain (A. Kaye and N. Vadivelu, Section Editors)
  • Published:
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Abstract

Purpose of Review

As ambulatory surgery has become increasingly more common, the appropriate management of anticoagulation therapy in patients undergoing invasive procedures has become progressively more relevant to healthcare professionals. The purpose of this literature review is to provide an overview of current common anaticoagulants and their pharmacological properties and to evaluate recent relevant literature and bridging therapy and provide recommendations on risk-guided therapy.

Recent Findings

With the development of new drugs and the advancing study and practice of anticoagulation use, clinicians must keep up-to-date on the optimal management of patients requiring anticoagulation. NOACs and warfarin continue to be the mainstays of treatment, with varying timelines regarding when to hold administration of the different agents within the perioperative period.

Summary

There are numerous factors that are considered in patients with multiple comorbidities including the risk for stroke on long-term anticoagulation and risk for thromboembolism, particularly in the perioperative setting when certain medication regimens may be altered and/or briefly held. There is ongoing investigation whether certain NOACs have more efficacy or greater safety profiles, depending on the degree of surgical intervention.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, NYU-Winthrop Hospital, 222 Station Plaza North Suite 598, Mineola, NY, USA

    Alice M. Kai

  2. Department of Anesthesiology, Yale University School of Medicine, TMP3 333, Cedar Street, New Haven, CT, USA

    Nalini Vadivelu, Shikha Shukla, Rob Schonberger & Trevor Banack

  3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA

    Richard D. Urman

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  1. Alice M. Kai
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Correspondence to Alice M. Kai.

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Alice M. Kai, Nalini Vadivelu, Richard D. Urman, Shikha Shukla, Rob Schonberger, and Trevor Banack declare no conflict of interest.

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Kai, A.M., Vadivelu, N., Urman, R.D. et al. Perioperative Considerations in the Management of Anticoagulation Therapy for Patients Undergoing Surgery. Curr Pain Headache Rep 23, 13 (2019). https://doi.org/10.1007/s11916-019-0747-3

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  • DOI: https://doi.org/10.1007/s11916-019-0747-3

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