Surgery in a warfarinized patient (365/1700)

A man on warfarin posted for hemicolectomy. As the pt is about to undergo surgery. What
option is the best for him?
a. Continue with warfarin
b. Continue with warfarin and add heparin
c. Stop warfarin and add aspirin
d. Stop warfarin and add heparin
e. Stop warfarin

























answer: D

pre-operative medications to stop
  • oral hypoglycemics
  • antidepressants: stop on morning of surgery
  • ACE inhibitors and angiotension receptor blockers: stop on morning of surgery
  • warfarin (consider bridging with heparin)
  • anti-platelet agents (e.g. clopidogrel)

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