Newer oral anticoagulants in perioperative settings

ABSTRACT

Newer oral anticoagulant agents [NOACs] have several potential merits over previously used vitamin K antagonists [VKAs] during the perioperative period, including a wider therapeutic index, higher efficacy, quicker onset and offset of action, high oral bioavailability, less need for monitoring, reduced variability in dose response and drug/dietary interactions and less adverse effects. These oral anticoagulants have discrete targets within the coagulation pathway. The patients on these drugs often present to anesthesiologists for routine or emergency surgery, hence the awareness of the pharmacological profile of these newer drugs is imperative to attain its optimal response. This update describes some of the new generation oral anticoagulants and focuses on its merits and demerits in the existing perioperative settings