Anticoagulation and bleeding risk assessment is a vital part of anesthesia planning, as many patients undergoing surgery are on blood-thinning medications or have underlying bleeding disorders. Improper management can lead to excessive bleeding, hematoma formation, or life-threatening thromboembolic events. Anesthesia teams must balance the risk of bleeding against the risk of clot formation when managing these patients.

Common anticoagulants include warfarin, direct oral anticoagulants, antiplatelet agents, and injectable anticoagulants. Patients may be on these medications for conditions such as atrial fibrillation, deep vein thrombosis, pulmonary embolism, or mechanical heart valves. Each medication requires specific timing for discontinuation or bridging before surgery.

Pre-anesthesia assessment involves reviewing medication history, indication for anticoagulation, coagulation test results, and bleeding history. Surgical bleeding risk and suitability for regional anesthesia are carefully evaluated. Multidisciplinary coordination with surgeons and physicians is essential.

Intraoperatively, anesthesia teams monitor for bleeding and maintain hemodynamic stability. Regional anesthesia techniques are used cautiously to avoid spinal or nerve hematoma. Blood conservation strategies may be employed in high-risk cases.

Postoperatively, anticoagulation is resumed at an appropriate time to prevent thrombosis while minimizing bleeding risk. Close monitoring ensures early detection of complications.

Through careful risk assessment and planning, anesthesia teams safely manage anticoagulation and bleeding risk in surgical patients.