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Anticoagulants and surgery: What do you need to know before surgery?
Anticoagulants, also known as blood thinners, are chemicals that prevent or reduce blood clotting, thereby prolonging the clotting time.This type of drug is taken by many people due to various diseases, including atrial fibrillation, deep venous thrombosis and heart disease.The use of these drugs can effectively reduce the risk of thrombosis, but it also brings certain bleeding risks, especially in the case of surgery, which is a question that every patient and his medical team must consider carefully.
Anticoagulants are a class of drugs closely linked to antiplatelet and thrombolytic drugs, intended to prevent different processes after blood clotting.
What is an anticoagulant?
The main function of anticoagulants is to interfere with the process of blood clotting, which generally prevents the activity of certain coagulation factors.These drugs are widely used in the medical community, including old warfarin and heparin, as well as newer direct oral anticoagulants, such as dabigatran and apixaban.These drugs are used to treat various cardiovascular diseases, however, patients using anticoagulants need to measure the risk of bleeding before surgery is about to occur.
Potential risks in surgery
One of the biggest risks during surgery is bleeding.Patients who have received anticoagulants may experience non-major or significant bleeding events during the procedure.Many experts recommend discussing the coagulation status with the patient before the surgery to make a decision on whether to discontinue the anticoagulant after a risk assessment.
Patients undergoing surgery should consider the use of anticoagulants and plan necessary changes to reduce the risk of bleeding.
Usage and surgical plan of anticoagulants
Before planning a surgery, doctors usually consider the type of surgery and its relative risks based on the characteristics of different anticoagulants.For example, for some simple dental procedures, continuous use of anticoagulants may be feasible.However, in surgery where a large-scale incision is required, it may be necessary to temporarily discontinue the anticoagulant a few days before the operation.
Related Investigations and Guidelines
Many medical studies have shown that discontinuing anticoagulants can indeed reduce the risk of bleeding.However, this increases the risk of thrombosis, especially in patients with a history of atrial fibrillation or deep venous thrombosis.Developing an appropriate treatment plan requires the medical team to carefully evaluate individual risks for each patient, such as using HAS-BLED or CHA2DS2-VASc metrics to predict the likelihood of bleeding.
Contraindicated foods and supplements
Certain foods and supplements have the effect of promoting or inhibiting coagulation.For example, some herbs, fish oil, garlic, etc. are believed to enhance the effect of anticoagulants, while dark green vegetables may interfere with the effect of anticoagulants.Therefore, patients should avoid ingesting such foods before surgery to maintain consistency of anticoagulant doses and ensure safety in the surgery.
Using of plasma reversal agents
To handle sudden bleeding events during surgery, medical institutions usually provide reversal agents.When using warfarin, vitamin K or freshly frozen plasma is commonly used in clinical practice to reverse its effect.Additional attention is needed for new direct anticoagulants, because the current reversal agents on the market are still limited, and treatment must be very cautious.
Conclusion
The use of anticoagulants becomes an important issue when patients are considering surgery.The medical team needs to evaluate the impact of the ongoing anticoagulant condition on the surgery and fully communicate with the patients about risks and benefits.For patients who are undergoing anticoagulant treatment, understanding their blood status and whether the upcoming surgery increases the risk of bleeding is a key step to ensure the success of the surgery.Are the preparations before the surgery sufficient and can we clearly understand the impact of anticoagulants?
