warfarin standard risk
warfarin standard risk
Preoperative
Withhold warfarin 5 days prior to surgery.
No bridging required.
Day before surgery; if INR is >1.5 give vitamin K 1-2mg orally.
Morning of surgery; if INR >1.5 defer sugery or if urgent consider Prothrombinex-VF (30-50 U/kg) plus FFP (1 unit, 275ml).
Postoperative
Restart on the night of surgery, at the previous maintenance dose, only if there is no evidince of significant haemorrhage.