Should Antithrombotics Be Stopped Before Wide-Awake CTR Surgery?

Antithrombotic agents may be safely continued by patients undergoing wide-awake surgery
Antithrombotic agents may be safely continued by patients undergoing wide-awake surgery

HealthDay News — For patients undergoing wide-awake carpal tunnel release (CTR) surgery, antithrombotic (AT) agents may be safely continued, according to a research letter published online November 29 in JAMA Surgery.

Sarah E. Sasor, MD, from Indiana University in Indianapolis, and colleagues conducted a retrospective study of wide-awake CTR procedures. Patients were classified as those taking oral AT agents at the time of surgery and those who were naive to AT agents. A total of 304 CTR procedures were performed on 246 patients during the study period; 32.6 percent of patients were taking prescribed AT agents at the time of surgery. 

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Ninety-three of the 99 patients taking AT medication continued their normal regimen through surgery and were included in the analysis. The researchers found that there were no significant differences for the AT and non-AT groups for estimated blood loss (3.94 versus 3.89 mL; P=0.87) or operative time (22 versus 23 minutes; P=0.38). The AT and non-AT groups had similar rates of postoperative complications (5.4 versus 4.9%; P>0.99). There were no reports of hematomas or neurological complications; no patients required reoperation.

"There are few reports on the effects of AT on elective hand surgery, and to our knowledge, this study is the first to provide evidence that AT medications may be safely continued in wide-awake CTR with or without a tourniquet," the authors write.

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