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O uso de drogas anticoagulantes e antiplaquet rias orais em pacientes cir£rgico-ambulatoriais – revisÆo de literatura / The use of anticoagulants and oral antiplatelet drugs in outpatient surgical patients – literature review
Santiago Junior, Joel Ferreira; Brambilla, Talita Gome; Ponzoni, Daniela; Aranega, Alessandra Marcondes; Pellizzer, Eduardo Piza; Santos, Pamela Let¡cia dos.
  • Santiago Junior, Joel Ferreira; s.af
  • Brambilla, Talita Gome; s.af
  • Ponzoni, Daniela; Universidade Estadual Paulista. São José do Rio Preto. BR
  • Aranega, Alessandra Marcondes; Universidade Estadual Paulista. São José do Rio Preto. BR
  • Pellizzer, Eduardo Piza; Universidade Estadual Paulista. São José do Rio Preto. BR
  • Santos, Pamela Let¡cia dos; s.af
Full dent. sci ; 6(21): 45-52, dez. 2014.
Article in Portuguese | LILACS, BBO | ID: lil-750181
RESUMO
Os anticoagulantes orais (AOC) e antiagregantes plaquet rios sÆo drogas utilizadas para a preven‡Æo de fen“menos tromboemb¢licos, como tromboembolismo pulmonar em pacientes com fibrila‡Æo atrial e/ou v lvulas card¡acas, trombose e embolismo pulmonar. Para pacientes submetidos a procedimentos cir£rgico-odontol¢gico eram solicitados a interromperem o uso dos anticoagulantes at‚ que o valor do INR se mantivesse ≤que 2.0, de modo a evitar hemorragias no trans e p¢s-operat¢rio. No entanto, a interrup‡Æo do AOC pode causar a forma‡Æo de um co gulo, levando a obstru‡Æo das vias sangu¡neas. Sendo assim, tornava-se duvidosa a interrup‡Æo do medicamento para a realiza‡Æo de cirurgias odontol¢gicas, em que medidas hemost ticas locais seriam suficientes para promover hemostasia. Deste modo, o objetivo da revisÆo foi avaliar o risco de hemorragia em pacientes usu rios de AOC que sÆo submetidos a procedimentos cir£rgicos, por meio de um levantamento bibliogr fico realizado em estudos cl¡nicos relevantes publicados entre 1990 e 2012, pela base Medline/PubMed. Nesta revisÆo de literatura concluiu- se que o benef¡cio da preven‡Æo de tromboembolismo supera o risco de hemorragia, assim sendo, recomenda-se manter a dose da terapia com anticoagulantes inalterada para pacientes submetidos … cirurgia oral menor e Implantodontia, utilizando n¡veis de INR adequado, com aux¡lio de hemost tico locais. Al‚m disto, uma t‚cnica cir£rgica apurada deve ser realizada nestes pacientes. Com rela‡Æo … cirurgia oral mais invasiva com risco de hemorragia, pode ser necess rio o tratamento em conjunto com a equipe m‚dica.
ABSTRACT
The oral anticoagulants (AOC) and platelet antiagregants are drugs used for the prevention of thromboembolic phenomena, such as pulmonary embolism in patients with atrial fribrilation heart valves, thrombosis and pulmonary embolism. For patients who are undergoing surgical procedures-dentistry were asked to discontinue the use of anticoagulants until the value of the INR remained≤2.0, that in order to avoid trans and hemorrhages in the postoperative period. However, the AOC can cause the formation of a clot, leading to obstruction of blood pathways. Thus, it became doubtful the medicine for surgery, in which local hemostatic measures would be sufficient to promote hemostasis. Thus, the objective of the review was to evaluate the risk of bleeding in patients AOC users that are subjected to surgical procedures, through a bibliographical survey carried out in relevant clinical studies published between 1990 and 2012, by the MedlinePubMed data. In this review of literature was concluded that the benefit of thromboembolism prevention overcomes the risk hemorrhage, therefore, it is recommended to keep the dose of anticoagulant therapy unchanged for patients undergoing oral surgery and implant dentistry, using appropriate INR levels with the assistance of local hemostatic. In addition, a refined surgical technique should be performed in these patients. With respect to the most invasive oral surgery, with a risk of bleeding, treatment may be necessary in conjunction with the medical staff.
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Index: LILACS (Americas) Main subject: Surgery, Oral / Thrombosis / Hemostasis / Anticoagulants Type of study: Practice guideline Language: Portuguese Journal: Full dent. sci Journal subject: Dentistry Year: 2014 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Estadual Paulista/BR

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Index: LILACS (Americas) Main subject: Surgery, Oral / Thrombosis / Hemostasis / Anticoagulants Type of study: Practice guideline Language: Portuguese Journal: Full dent. sci Journal subject: Dentistry Year: 2014 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Estadual Paulista/BR