“Should all medications be stopped before anesthesia?”
I take blood thinners. Should I stop taking them before I have anesthesia for my surgery next month?
18 Answers
Dr. J. Arthur Saus
Anesthesiologist
This is a much broader question that it appears you intended to ask. There are many different types of "blood thinners" and there are different approaches to anesthesia. The correct answer to your question depends on the combination of your medical problem for which you are taking these "blood thinner" medications, the specific "blood thinner" and any other medications you may also be taking, and the specific surgical procedure and anesthesia that will be used. There can be no single complete answer for your question, even though I trust you felt you were asking a simple, straightforward question. This is something that should be discussed in detail with your anesthesiologist prior to surgery in the pre-op evaluation. The answer must be tailored specifically for your individual situation.
You should stop your blood thinners as directed by your surgeon and the physician prescribing them.
Consult with your surgeon and the doctor prescribing the blood thinners
Depends on why you are taking them and the type of surgery. Talk to your surgeon and anesthesiologist
Good question. There are surgeries that do not require that a Blood Thinner be stopped. Also in my practice we will check with the Doctor that has you on Blood Thinners so they can tell us if it needs to be stopped. If it can not be stopped we will then setup "Bridge therapy" where a short acting Blood Thinner is started at the same time that your regular Blood Thinner is stopped. This Bridge Therapy can be stopped the Day of Surgery so you can safely have surgery off Blood Thinners. The Bridge therapy Blood Thinner is then restarted postop till you are ready to start your regular med again.
"Blood thinners" are typically anti-coagulants such as Coumadin or Xarelto or Heparin,however anti-platelet medication such as Aspirin or Plavix can get put into this category. The decision to stop medications is made with your internist, your surgeon and anesthesiologist. This will likely depend on the reasons you are on anti-coagulants, and the procedure you are having done. Checking with your physicians prior to the procedure especially with regards to anti-coagulants is important.
Many groups recc 1 or 2 weeks to hold this med. But depends what procedure and condition of patients. Eye surgeries now are done without stopping them if pte is at risk, i.e., stent. Also cardio performs procedures under blood thinning meds. Ortho is different. At least 5 days is required. For elective procedures, I say 1 week.
Blood thinners must be thoughtfully managed before anesthesia and surgery. Some medications are stopped, some have a dose change, some are switched to a different type of medication, and others are not stopped or changed. It all depends on the medication, the reason you are taking it, and the type of surgery you have planned. Please discuss your medications with your surgeon or have a consultation with an anesthesiologist. Medications other than blood thinners may also require specific management before and after surgery.
No
Ask your surgeon. Most want you to stop blood thinners.
No. They are taken 2 hours prior surgery time. Except for insulin and hypoglycemic diabetic pills and diuretics. Aspirin and anticoagulants as per surgeon request
In general, you should always consult with your surgeon and your
anesthesiologist about which medicines should be taken or stopped before
surgery. Blood thinners are a special category where the answer depends on
why you are taking the drug and what kind of surgery you are having. For
minor surgery where no blood loss is expected, continuing blood thinners is
usually prescribed. If you are taking blood thinners to protect the
patency of a coronary stent, or if you are having major surgery with a
significant risk of blood loss, then you should consult with your
internist, cardiologist, surgeon, and anesthesiologist weeks in advance.
They may ask you to change blood thinning medications, have your clotting
parameters checked with blood testing, and make a plan for stopping and
restarting your blood thinners.
anesthesiologist about which medicines should be taken or stopped before
surgery. Blood thinners are a special category where the answer depends on
why you are taking the drug and what kind of surgery you are having. For
minor surgery where no blood loss is expected, continuing blood thinners is
usually prescribed. If you are taking blood thinners to protect the
patency of a coronary stent, or if you are having major surgery with a
significant risk of blood loss, then you should consult with your
internist, cardiologist, surgeon, and anesthesiologist weeks in advance.
They may ask you to change blood thinning medications, have your clotting
parameters checked with blood testing, and make a plan for stopping and
restarting your blood thinners.
It depends on which blood thinners, why you are on them and the type of surgery. For cataract surgery, you don't need to stop them. If you are on warfarin with a mitral valve replacement for major surgery, you will have to be "bridged" with an injectable anticoagulant for up to a week before the surgery. Please discuss this with your surgeon at least 3 weeks before your surgery.
Steven Dain MD, FRCPC
Steven Dain MD, FRCPC
No.You should consult with your
Doctor and Anesthesiologisr
Doctor and Anesthesiologisr
Blood thinners have no effect on anesthesia. They do have major impact on surgery. Most surgeries require stopping blood thinners few days in advance at discretion of your cardiologist or primary doctor.
This is a issue where more information is needed to give a good answer. The
type of medication taken, the clinical reasons for taking the medication,
and the type of surgery must all be considered before giving you an answer.
Consult your surgeon and the physician who prescribed the blood thinners
before any decision to stop or "hold' medication. You wouldn't want to have
your surgery canceled or delayed unnecessarily due to a miscommunication or
misunderstanding. You can do an internet search of guidelines for holding
medications prior to surgery, but as I said, you must consult both the
surgeon and the physician responsible for prescribing your blood thinning
medication. Some medications may need to be discontinued for a significant
amount of time, so make your inquiries as early in the process as possible.
Other medications may be continued before surgery, particularly heart and
blood pressure medications. Be sure to let your surgeon and
other physicians know which medications you are taking. Don't forget to
mention all non prescription, vitamin, and herbal medications also. Be sure
to ask when you should restart any medications which you may have stopped
for surgery. Good luck with your procedure!
type of medication taken, the clinical reasons for taking the medication,
and the type of surgery must all be considered before giving you an answer.
Consult your surgeon and the physician who prescribed the blood thinners
before any decision to stop or "hold' medication. You wouldn't want to have
your surgery canceled or delayed unnecessarily due to a miscommunication or
misunderstanding. You can do an internet search of guidelines for holding
medications prior to surgery, but as I said, you must consult both the
surgeon and the physician responsible for prescribing your blood thinning
medication. Some medications may need to be discontinued for a significant
amount of time, so make your inquiries as early in the process as possible.
Other medications may be continued before surgery, particularly heart and
blood pressure medications. Be sure to let your surgeon and
other physicians know which medications you are taking. Don't forget to
mention all non prescription, vitamin, and herbal medications also. Be sure
to ask when you should restart any medications which you may have stopped
for surgery. Good luck with your procedure!
It depends on which blood thinners you take as nowadays there are so many of them and most importantly why. I would check with your family physician or anesthetist before you come in for the procedure.
Hi,
Blood thinners do increase the risk of bleeding. Now, you don't need to stop blood thinners with every surgery and it depends on the blood thinner, your medical conditions and type of surgery. You need to work in conjunction with your surgeon, primary care physician and specialists as to when to stop and start your blood thinner. Anesthesia techniques can be custom-tailored around your blood thinner regiment.
Good luck
Dr Ketch
Blood thinners do increase the risk of bleeding. Now, you don't need to stop blood thinners with every surgery and it depends on the blood thinner, your medical conditions and type of surgery. You need to work in conjunction with your surgeon, primary care physician and specialists as to when to stop and start your blood thinner. Anesthesia techniques can be custom-tailored around your blood thinner regiment.
Good luck
Dr Ketch
