Perioperative preparation for oral surgery in patients on anticoagulant or antiplatelet therapy
DOI:
https://doi.org/10.14748/dhw6ax42Keywords:
anticoagulants, antiplatelet drugs, perioperative management, oral surgeryAbstract
The most common cause of deviation in coagulation status is the systemic administration of anticoagulants (ACs) and antiplatelet drugs (APs). The two types of drugs act at different stages of the coagulation cascade. Knowledge of their pharmacokinetics and pharmacodynamics is a prerequisite for adequate preoperative planning and postoperative control. The present review aims to investigate and discuss perioperative management in patients on anticoagulant and antiplatelet therapy undergoing oral surgery. The Web of Science, PubMed, Scopus, and Google Scholar databases were searched for appropriate studies using the following keywords: anticoagulants, antiplatelet drugs, perioperative management, and oral surgery. Perioperative management of patients on anticoagulant and antiplatelet therapy depends on the type, volume, and duration of the surgical intervention, the class and type of medication administered, and some patient-related factors, such as age, comorbidity, individual risk of spontaneous hemorrhage, congenital coagulopathy, etc. The approach in these patients is multidisciplinary and requires the assessment of the specialist who prescribed the treatment (cardiologist, neurologist, vascular surgeon, etc.) and the oral surgeon and anesthesiologist. Some deviations in the coagulation status require prolonged inpatient follow-up. Therefore, it is necessary to perform a careful and thorough analysis of whether the surgery can be performed in an ambulatory setting or a hospital unit.
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