Document Detail


Can warfarin be continued during dental extraction? Results of a randomized controlled trial.
MedLine Citation:
PMID:  12054719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A randomized controlled trial was set up to investigate whether patients who were taking warfarin and had an International Normalised Ratio (INR) within the normal therapeutic range require cessation of their anticoagulation drugs before dental extractions. Of 109 patients who completed the trial, 52 were allocated to the control group (warfarin stopped 2 days before extraction) and 57 patients were allocated to the intervention group (warfarin continued). The incidence of bleeding complications in the intervention group was higher (15/57, 26%) than in the control group (7/52, 14%) but this difference was not significant. Two patients in the study required hospital review for bleeding and all other episodes of bleeding were controlled by patients at home. Continuing warfarin when the INR is < 4.1 may lead to an increase in minor post-extraction bleeding after dental extractions but we found no evidence of an increase in clinically important bleeding. As there are risks associated with stopping warfarin, the practice of routinely discontinuing it before dental extractions should be reconsidered.
Authors:
I L Evans; M S Sayers; A J Gibbons; G Price; H Snooks; A W Sugar
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The British journal of oral & maxillofacial surgery     Volume:  40     ISSN:  0266-4356     ISO Abbreviation:  Br J Oral Maxillofac Surg     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-10     Completed Date:  2002-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8405235     Medline TA:  Br J Oral Maxillofac Surg     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  248-52     Citation Subset:  D; IM    
Copyright Information:
Copyright 2002 The British Association of Oral and Maxillofacial Surgeons.
Affiliation:
Maxillofacial Unit, Morriston Hospital, Swansea, UK.
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / therapeutic use
Adult
Aged
Aged, 80 and over
Analgesics, Non-Narcotic / therapeutic use
Anesthetics, Local / administration & dosage
Anticoagulants / administration & dosage,  therapeutic use*
Chi-Square Distribution
Confidence Intervals
Female
Follow-Up Studies
Hemostasis, Surgical
Humans
International Normalized Ratio
Lidocaine / administration & dosage
Male
Middle Aged
Oral Hemorrhage / etiology
Postoperative Hemorrhage / etiology
Risk Factors
Statistics as Topic
Tooth Extraction*
Warfarin / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Anesthetics, Local; 0/Anticoagulants; 103-90-2/Acetaminophen; 137-58-6/Lidocaine; 81-81-2/Warfarin
Comments/Corrections
Comment In:
Br J Oral Maxillofac Surg. 2003 Apr;41(2):132   [PMID:  12694713 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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