Clinical study of bleeding index in oral surgery in patients under anticoagulant or antiplatelet therapy

Carla Salvi, Luiz Alberto Formighieri, Rosana da Silva Berticelli, Fabiana Seguin, Greison Rabelo de Oliveira

Introduction: It was performed a clinical evaluation of the incidence of bleeding in various oral surgical procedures in patients taking anticoagulants (such as warfarin sodium and heparin) or antiplatelet therapy (such as acetylsalicylic acid), as well as the efficacy of tranexamic acid, maintaining patient’s protection against the occurrence of thromboembolic episodes. Methods: 31 surgeries were performed, 17 in male patients and 14 in female patients, having as inclusion criteria the use of anticoagulant or antiplatelet therapy, and INR value within the therapeutic range. In none case, medication was suspended or altered. It was evaluated the type of surgical intervention, thromboembolic risk, bleeding during surgery and post-surgery, and the need for local measures to control hemorrhage. Results: The maintenance of anticoagulant or antiplatelet medication did not trigger an increase in the bleeding index. Only 2 patients (6.45%) were observed with bleeding that was not normal in the intraoperative period, both of which were reversed through tranexamic acid tamponade. Considering the postoperative bleeding index, classified as mild, moderate or severe, only 1 patient (3.22%) developed severe hemorrhage after the fourth day, due to external factors, with the others presenting mild bleeding. There was no thromboembolic episode recorded during the study. Conclusions: The trans and postoperative bleeding index in the performed surgical procedures remained, in the great majority of our patients, within normal, that is, controlled and with good visibility of the operative field. Still, new studies may contribute to further elucidations.

Keywords: Thromboembolism. Anticoagulants. Tranexamic acid.

How to cite: Salvi C, Formighieri LA, Berticelli RS, Seguin F, Oliveira GR. Clinical study of bleeding index in oral surgery in patients under anticoagulant or antiplatelet therapy. J Clin Dent Res. 2017 Oct-Dec;14(4):92-100. DOI: https://doi.org/10.14436/2447-911x.14.4.092-100.oar

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