Basics and Perioperative Management of Antithrombotics

Abstract

In the era of direct oral anticoagulants, physicians are expected to manage patients with anticoagulation therapy appropriately based on the characteristics of each anticoagulant. Physicians must consider both bleeding and thrombosis risks in perioperative management because maintaining a balance between these risks is crucial. The management of patients with anticoagulation therapy in emergency surgery is challenging for anesthesiologists because bleeding risk is usually higher than in elective surgery. Recently, specific antidotes to direct oral anticoagulants have been shown to be effective in bleeding due to anticoagulants, but these agents are generally expensive. Physicians need to understand the characteristics of antidotes as well as anticoagulants.