Urgent Surgery & Anticoagulation

Warfarin has to be stopped 5 days before elective surgery, with Oral Vit K given the day before surgery if INR 5+.

Most pre-operative patients will be given bridging (interim therapy) with a LMWH, such as enoxaparin or dalteparin, as it can be much more easily stopped and re-started.

If the surgery is an emergency:

• If it can be delayed for 6–12 hours - give IV Vit K

• If it can’t be delayed - give Prothrombin complex precipitate and IV Vit K