Abstract
Introduction: Continuous oral anticoagulant therapy has been used to decrease the risk of thromboembolism for more than
half a century, prolonging the lives of thousands of patients. There is increased risk of haemorrage doing dental procedures
in patients on anticoagulant and antiplatelet therapy. Many physicians recommend interrupting continuous anticoagulant therapy for dental surgery to prevent haemorrhage. Tranexamic acid (TXA) is a good antifibrinolitic agent. In this study the evaluation of its haemostatic effect in post extraction haemorrhage by using pressure pack of TXA in patients on anticoagulant and antiplatelet therapy, has been studied.
Aims and Objectives: The purpose of this study was to evaluate the post extraction control of haemorrhage with administration of TXA as pressure pack in patients on anticoagulant and antiplatelet therapy.
Materials and Methods: Extraction was performed by pre-operative international normalised ratio (INR) and haemogram test without stoppage of anticoagulant therapy. Ten patients with history of anticoagulant and antiplatelet therapy requiring extraction of teeth were included in this study.
Results: Records showed no instances of post extraction bleeding, except in 1 and whom intravenous TXA was given, which the bleeding was controlled. No TXA allergy was noted. And postoperative control of haemorrhage was there acceptable in all the cases.
Conclusion: Extraction can safely be carried out without discontinuation of anticoagulant and antiplatelet therapy in vulnerable group of patients.
Keywords
Full Text:
References
Sindet-Pedersen S, Ramstrom G, Bernvil S, Blomback M. Haemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. N Engl J Med 1989; 320: 840-843.
Borea G, Montebugnoli L, Capuzzi P, Magelli C. Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery. An alternative method to discontinuing anticoagulant therapy. Oral Surg Oral Med Oral Pathol 1993; 75: 29-31.
Ramstrom G, Sindet-Pedersen S, Hall G, Blomback M, Alander U. Prevention of post-surgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants. J Oral Maxillofac Surg 1993; 51:1211-1216.
Souto J C, Oliver A, Zuazu-Jausoro I, Vives A, Fontcuberta J. Oral surgery in anticoagulated patients without reducing the dose of oral anticoagulant: A prospective randomised study. J Oral Maxillofac Surg 1996; 54: 27-32.
Gaspar R, Brenner B, Ardekian L, Peled M, Laufer D. Use of tranexamic acid mouthwash to prevent post-operative bleeding in oral surgery patients on oral anticoagulant medication. Quintessence Int 1997; 28: 375-378.
Sindet-Pedersen S, Sternbjerg S. Effect of local antifibrinolytic treatment with tranexamic acid in haemophiliacs undergoing oral surgery. J Oral Maxillofac Surg 1986; 44: 703-707.
B. V. Bajkin, I. A. Bajkin, and B. B. Petrovic, “ e e ects of combined oral anticoagulant-aspirin therapy in patients undergoing tooth extractions: a prospective study,” Journal of the American Dental Association, vol. 143, no. 7, pp. 771–776, 2012.
Chye E P Y, Young I G, Osborne G A, Rudkin G E. Outcomes after same- day oral surgery: A review of 1,180 cases at a major teaching hospital. J Oral Maxillofac Surg 1993; 51: 846-849.
Yee K F, Davis A C. One year's experience in a new dental day-stay unit. Anaesth Intensive care 1984; 12: 131-136.
Vickers P, Goss A N. Day-stay oral surgery. Australian Dent J 1983; 28: 135-138.
Bruce R A, Frederickson G C, Small G S. Age of patients and morbidity associated with mandibular third molar surgery. JADA 1980; 101: 240-245.
Bjoerlin G, Nilsson I N. Fibrinolytic activity in alveoli after tooth extraction. Odontol Rev 1968; 19: 197-204.
Sisk A L, Hammer W B, Shelton D W, Joy E D. Complications following removal of impacted third molars: The role of the experience of the surgeon. J Oral Maxillofac Surg 1986; 44: 855-85
Lindberg F, Bergqvist D, Rasmussen I. Incidence of thromboembolic complications after laparoscopic cholecystectomy: review of the literature. Surg Laparosc Endosc. 1997;7(4):324-331
Rowbotham BJ, Whitaker AN, Harrison J, Murtaugh P, Reasbeck P, Bowie EJ. Measurement of crosslinked fibrin derivatives in patients undergoing abdominal surgery: use in the diagnosis of postoperative venous thrombosis. Blood Coagul Fibrinolysis.
;3(1):25-31.
Refbacks
- There are currently no refbacks.