Anesthesia for anticoagulated patients

BACKGROUND: Anticoagulated patients who undergo surgry have been increasing in number. They may develop thrombo-embolic and/or bleeding complications. METHODS: We studied 79 patients retrospectively who had undergone elective surgery from April 2002 through December 2003. We studied their basal diseases, types of anticoagulants, stopping or continuing anticoagulants during their surgical period, thrombo-embolic and/or bleeding complications and changing of the anesthetic method. RESULTS: Thrombo-embolic complications occurred in 2 patients (2.5%) who developed brain emboli. Both of them had arythmia. Bleeding complications occurred in 4 patients (5.1%), of whom 3 patients developed bleeding during spinal or epidural anesthesia and one of them had hematoma from the surgical wound. There was no mortality, and 28.8% of patients underwent change of anesthetic method where only general anesthesia was used. CONCLUSIONS: It is recommended that patients at high risk of thrombo-embolism should continue to receive anticoagulant or heparin during surgical period.