Why the study?
Does performing minor oral surgical procedures without altering long-term anticoagulant therapy increase the risk of excessive hemorrhage in patients with an INR of 3-4?
Does performing minor oral surgical procedures without altering long-term anticoagulant therapy increase the risk of excessive hemorrhage in patients with an INR of 3-4?
Minor oral surgical procedures and extractions can be safely performed without altering long-term anticoagulant therapy in patients with an INR of 3-4.
Answers are grounded in this paper and cite their sources.
May support continuing anticoagulation for minor oral surgery at INR 3-4; leaves open confirmation in prospective trials.
INTRODUCTION: The risk of postoperative hemorrhage from oral surgical procedures has been a concern in the treatment of patients who are receiving long-term anticoagulation therapy. A study undertaken in our institution to address questions about the amount and severity of bleeding associated with minor outpatient oral surgery procedures by assessing bleeding in patients who did not alter their anticoagulant regimen. SUBJECTS AND METHODS: Eighty-three patients receiving long-term anticoagulant therapy visited Department of Oral and Maxillofacial Surgery from May 2010 to October 2011 for extractions and minor oral surgical procedures. Each patient was required to undergo preoperative assessment of prothrombin time (PT) and measurement of the international normalized ratio. Fifty-six patients with preoperative PT values within the therapeutic range 3-4 were included in the study. The patients' age ranged between 30 and 75 years. Application of surgispon was done following the procedure. Extraction of teeth performed with minimal trauma to the surrounding tissues, the socket margins sutured, and sutures removed after 5 days. RESULTS: There was no significant incidence of prolonged or excessive hemorrhage and wound infection and the healing process was normal.
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Amaldhas et al. (2015) studied this question.
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