Perioperative management of patients receiving long-term antithrombotic therapy. Russian Federation of anesthesiologists and reanimatologists guidelines

The review presents the clinical guidelines of the Federation of Anaesthesiology and Resuscitation specialists of Russia, revised in 2018. The recommendations are based on a review of publications and modern international guidelines of the British Hematology Standards Committee (BSH, 2016), the European Society of Cardiology in partnership with the European Society of Cardiothoracic Surgeons (ESC and EACTS, 2018), the American Society of Regional Anesthesia and Pain (ASRA, 2018), The European Society of Anesthesiologists (ESA, 2010), as well as a consensus document of an interdisciplinary group of experts of the Russian Federation. Perioperative management of patients receiving long-term antithrombotic (antiplatelet and / or anticoagulant) therapy may be problematic, as they often need to interrupt antithrombotic therapy before surgery. In this, it is necessary to maintain a balance between the effectiveness of antithrombotic therapy and its safety by minimizing the frequency of both hemorrhagic and thrombotic complications. The recommendations presented in the review are aimed at achieving the strategic goal of perioperative antithrombotic therapy — minimizing the risk of bleeding subject to the minimum necessary antithrombotic potential.