The perioperative management of anticoagulation

Abstract

The perioperative management of patients on long-term warfarin therapy poses particular problems. This situation is exacerbated by the absence of randomized trials. The strategy used is based on the assessment of each patient's thromboembolic and bleeding risks. These determine the need for withholding warfarin and switching to heparin. Most patients having minor procedures can continue to take warfarin, provided that they are closely monitored and local measures are used to ensure adequate haemostasis.