scholarly journals Postoperative Bleeding Risk for Oral Surgery under Continued Clopidogrel Antiplatelet Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Alexander Gröbe ◽  
Meike Fraederich ◽  
Ralf Smeets ◽  
Max Heiland ◽  
Lan Kluwe ◽  
...  
Keyword(s):  
Oral Surgery ◽  
Postoperative Bleeding ◽  
Dual Therapy ◽  
Bleeding Risk ◽  
Study Groups ◽  
Postoperative Hemorrhage ◽  
Control Group ◽  
Outpatient Basis ◽  
Major Cardiovascular Events ◽  
Antiplatelet Medication

Object.To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin.Design.Retrospective single center observatory study of two study groups and a control group.Methods.A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis.Results.We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64 (1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0–1.7%, 0–4.7%, and 0–7.8%, respectively, and the incidences did not differ significantly among the three groups (P>0.09). Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded.Conclusions.Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin.

scholarly journals Effectiveness of Silicon Platelet-Rich Fibrin and Autologous Bone on Bone Regeneration in Rabbit Calvarian Defects: A Radiological and Histological Study

2021 ◽  
Vol 11 (9) ◽  
pp. 4074
Author(s):  
Argimiro Hernández-Suarez ◽  
María Rizo-Gorrita ◽  
Dubraska Suárez-Vega ◽  
Gladys Velazco ◽  
Ivan Rodriguez Gelfenstein ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Oral Surgery ◽  
Histological Study ◽  
Study Groups ◽  
Control Group ◽  
Graft Material ◽  
Platelet Rich Fibrin ◽  
Computed Microtomography ◽  
Autologous Bone ◽  
Group 2

Repairing bone defects in oral surgery often requires the use of bone regeneration techniques. Silicon is an element that has been employed as regeneration material in several studies. In our study, silicon was combined with autologous bone and platelet-rich fibrin (PRF) membranes to analyse the behaviour of this element in bone regeneration. Four circumferential defects were created in the cranial vault of five New Zealand rabbits. The following elements were applied to the regeneration of the defects: (P): PRF; (S): silicon and (B): autologous bone, with the following distribution of study groups: Group 1 (PSB); Group 2 (PS); Group 3 (SB) and Group 4 (CONTROL): unregenerate group. The animals were sacrificed after 3 weeks. Computed microtomography studies (μ-CT) were carried out, as well as histomorphometric ones. The ANOVA statistical test was used with a Bonferroni post-hoc test to compare the results (p ≤ 0.05). Radiologically, groups PSB and SB were better as far as quantity and percentage of healthy bone observed, but not significantly compared to the control group. The PS group was significantly worse. The histological test revealed that the PSB group was the one to present the largest area, percentage and perimeter of mineralised bone. On evaluating the forming bone (osteoid), no difference was observed across the groups with the exception of the bone perimeter, where the SB group was significantly better. The bone height variable showed no significant differences. In conclusion we can state that the combination of PRF, autologous bone and silicon provides good results at 3 weeks whilst the PS group shows the worst results. This highlights the importance of autologous bone forming part of the graft material in order for the bone to mineralise.

Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy

2015 ◽  
Vol 20 (6) ◽  
pp. 1279-1282 ◽  
Author(s):  
Henning Hanken ◽  
Alexander Gröbe ◽  
Max Heiland ◽  
Ralf Smeets ◽  
Lan Kluwe ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Surgery ◽  
Postoperative Bleeding ◽  
Bleeding Risk

The risk of postoperative hemorrhage and efficacy of heparin for preventing deep vein thrombosis and pulmonary embolism in adult patients undergoing neurosurgery: a systematic review and meta-analysis

2017 ◽  
Vol 65 (8) ◽  
pp. 1136-1146 ◽  
Author(s):  
Xuan Wang ◽  
Ying-Chun Zhou ◽  
Wen-De Zhu ◽  
Yun Sun ◽  
Peng Fu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Postoperative Hemorrhage ◽  
Adult Patients ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Heparin Prophylaxis

The aim of this meta-analysis was to examine the risk of postoperative bleeding and efficacy of heparin for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in adult patients undergoing neurosurgery. MEDLINE, Cochrane, and EMBASE databases were searched until October 31, 2016, for randomized controlled trials (RCTs) and non-randomized comparative studies that assessed the rates of postoperative hemorrhage, DVT, PE, and mortality in adult patients undergoing neurosurgery. Nine eligible studies (five RCTs, four retrospective studies) including 874 patients treated with either unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) and 1033 patients in control group (placebo with or without compression device) were analyzed. The overall analysis revealed that there was an increase in the risk of postoperative hemorrhage in patients who received heparin (pooled OR 1.66, 95% CI 1.01 to 2.72, p=0.046) compared with no treatment group. The risk of postoperative hemorrhage was more significant if only RCTs were included in analysis. Heparin prophylaxis was associated with a decrease in the risk of DVT (pooled OR 0.48, 95% CI 0.36 to 0.65, p<0.001) and PE (pooled OR 0.25, 95% CI 0.09 to 0.73, p=0.011) but it did not affect the rate of mortality. In conclusion, heparin increased the rate of postoperative bleeding, decreased the risk of DVT, PE and venous thromboembolic event (VTE) but it did not affect the mortality of patients undergoing neurosurgery. For the heparin prophylaxis, the trade-off between the risk of postoperative bleeding and benefit of prophylaxis against VTEs requires further investigation.

Risk of Bleeding during Implant Surgery in Patients Taking Antithrombotics: A Systematic Review

2021 ◽  
Author(s):  
Luciano Nascimento Braga Miziara ◽  
Wilson Roberto Sendyk ◽  
Karem López Ortega ◽  
Marina Gallottini ◽  
Daniel Isaac Sendyk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oral Surgery ◽  
Absolute Risk ◽  
Vitamin K Antagonists ◽  
Postoperative Bleeding ◽  
Antiplatelet Agents ◽  
Control Group ◽  
Antithrombotic Treatment ◽  
Risk Of Bleeding ◽  
Implant Placement

AbstractThe objective of this systematic review is to assess the risk of postoperative bleeding in oral surgery for implant placement in individuals taking antithrombotics (i.e., anticoagulants and/or antiplatelet agents). A literature search was performed in PubMed (MEDLINE), Web of Science, Scopus, and EMBASE databases for articles published until August 2020, with no date restriction, and manually completed. We included prospective clinical studies that provided information regarding the presence of an experimental group (i.e., implant placement), a control group (patients not under treatment with antithrombotics), and a well-established protocol for evaluating bleeding. Meta-analysis determined the risk of bleeding during the placement of implants in antithrombotic-treated patients. Of the 756 potentially eligible articles, 5 were included in the analysis with 4 ranked as high and 1 as medium quality. Antithrombotic treatment comprised the following drug classes: (1) anticoagulants: vitamin K antagonists, (2) nonvitamin K antagonist oral anticoagulants, (3) low-molecular-weight heparin, and (4) antiplatelet agents (not specified). The results suggest that the risk of bleeding is not substantially higher in antithrombotic-treated patients (odds ratio = 2.19; 95% confidence interval: 0.88–5.44, p = 0.09) compared with nontreated patients. This systematic review suggests that the absolute risk is low and there is no need to discontinue or alter the dose of the antithrombotic treatment for implant placement surgery.

Tranexamic Acid Tamponade to Control Postoperative Surgical Hemorrhage

2015 ◽  
Vol 41 (3) ◽  
pp. e82-e89 ◽  
Author(s):  
Dennis Flanagan
Keyword(s):  
At Risk ◽  
Tranexamic Acid ◽  
Acid Solution ◽  
Therapeutic Effect ◽  
Thromboembolic Event ◽  
Oral Surgery ◽  
Postoperative Bleeding ◽  
Postoperative Hemorrhage ◽  
Bleeding Site ◽  
Single Extractions

When preparing for oral surgery, patients taking anticoagulants usually should not discontinue their medication because of the risk of a thromboembolic event. The therapeutic effect of many anticoagulants is not readily measured, so preoperatively, the surgeon cannot know the true risk for postoperative hemorrhage. The risk of a thromboembolic event usually outweighs the concerns of controlling postoperative hemorrhage. Hemophilia patients are also at risk for postoperative bleeding. Single extractions probably do not pose a serious risk for postoperative hemorrhage. However, when a mucogingival flap is raised in these patients, there may be prolonged bleeding. Surgical sponges saturated with aqueous tranexamic acid solution and compressed onto the bleeding site with biting pressure may stop bleeding. Bleeding was stopped in the case example presented here after three 10-minute compressions over 30 minutes in a patient taking aspirin and clopidogrel for a previous thromboembolic event and a metal coronary stent. The clot formed is very fragile and is prone to bleeding, so it should not be disturbed. This technique needs to be studied for efficacy.

Effect of Modern Fibrin Glue on Bleeding after Tonsillectomy and Adenoidectomy

2003 ◽  
Vol 112 (5) ◽  
pp. 410-414 ◽  
Author(s):  
Michael Vaiman ◽  
Nathan Shlamkovich ◽  
Efraim Eviatar ◽  
Samuel Segal
Keyword(s):  
Blood Loss ◽  
Fibrin Glue ◽  
Randomized Study ◽  
Postoperative Bleeding ◽  
Postoperative Hemorrhage ◽  
Control Group ◽  
Surgical Trauma ◽  
Intraoperative Blood Loss ◽  
Secondary Hemorrhage ◽  
Needle Point

We performed a prospective randomized study in 179 patients to examine the second-generation surgical fibrin sealant Quixil as an effective substitute for different types of electrocautery in tonsillectomy and adenoidectomy. We compared the rates of hemorrhagic complications in a group with bipolar or needle point electrocautery and in a group in whom fibrin glue was used to stop intraoperative bleeding and to prevent postoperative bleeding. The operations were performed under general anesthesia in typical fashion with sharp dissection. For the control group, hemostasis was achieved by bipolar or needle point electrocautery. For the fibrin glue group, hemostasis was achieved by spraying Quixil fibrin glue approximately 0.5 mL to each tonsillar fossa and 0.5 mL to the nasopharynx (in adenoidectomy). The results were excellent in all the patients of the fibrin glue group, with complete hemostasis and resolution of the major symptoms. In this group, the intraoperative blood loss averaged 15 mL in tonsillectomy and 9 mL in adenoidectomy. There were no cases of postoperative hemorrhage or any other complications. The electrocautery group required a longer time for healing, and its intraoperative blood loss (tonsillectomy) averaged 29 to 33 mL. The incidence of posttonsillectomy bleeding in this group was 4.35% (4 patients). Three patients (3.26%) had primary hemorrhage (bleeding that occurs within the first 24 hours of surgery), and 1 patient (1.09%) had secondary hemorrhage (bleeding that occurs after the first 24 hours). We conclude that Quixil fibrin glue application to the operative sites in tonsillectomy and adenoidectomy provides effective hemostasis and sealing with good systemic and local compatibility. With the help of Quixil, we minimized surgical trauma and achieved absolute hemostasis at the same time. We found this fibrin glue to be a more convenient and effective hemostatic sealant than bipolar or needle point coagulation.

Sucrose and Facilitated Tucking for Pain Among Neonates Receiving Vaccination, in Puducherry

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Sujatha S. ◽  
Rebecca Samson ◽  
Christopher Amalraj ◽  
Sundaresan Sundaresan
Keyword(s):  
Sucrose Solution ◽  
Study Groups ◽  
Primary Outcome Measure ◽  
Intradermal Injection ◽  
Control Group ◽  
Intradermal Vaccination ◽  
Term Neonates ◽  
Bcg Vaccination ◽  
Pharmacologic Agents ◽  
Study Intervention

Neglected pain in neonates leads to various ill effects and it can be prevented by using simple and safe non-pharmacological pain relieving measures. Pharmacologic agents are not recommended in neonates for acute pain due toinvasive procedures however, administration of 24% oralsucrose solutionis found to be effective. The objective of this study was to assess the efficacy of 24%oral sucrose in combination with Facilitated tucking during BCG Vaccination through intradermalroute in term neonates which is not done elsewhere. Fifty five healthy term neonates who fulfilled the inclusion criteria such as gestational age above 37 weeks, within 24 hoursof birth age, and neonates delivered only through spontaneous vaginal delivery were included in the study. The study intervention consists of administration of 2 ml of oral 24% sucrose 2 minutes before BCG Vaccination through intradermal route and Facilitated tuckingat the time of vaccination. The primary outcome measure of cumulative NIPS score at 0, 3,5 minuteswas not significant in both the study groups. Whereas there was significant reduction in the level of pain and mean cry time in the neonates of sucrose group. Heart rateand oxygen saturation after intradermal injection also showed significant (p less than 0.001) differenceamong the neonates, who received 24% of oral sucroseand Facilitated tucking than for neonates of control group. Thus oral (24%)sucrose solution given 2 minutes before injection was effective in reducing level of neonatal pain following Intradermal Vaccination. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedures in term neonates which last for 5-7minutes.

Employing Gamma Ray Irradiated Giardia lamblia as Trialed Vaccine in Experimental Animal

2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Amal Kamil Abdul Sada ◽  
Amany Mohamed Al-Kaysi
Keyword(s):  
Giardia Lamblia ◽  
Gamma Ray ◽  
Age Groups ◽  
Active Phase ◽  
Study Groups ◽  
Negative Control ◽  
Control Group ◽  
High Dose ◽  
Histopathological Changes ◽  
Gamma Irradiated

This is an experimental trial to prepare a vaccine from gamma-irradiated Giardia lamblia which is evaluated in experimental animals. The study was conducted from December 2015 to April 2016. The field survey of the parasite was conducted from those patients attending the laboratories of the Alawi Children's Hospital in Rusafa and the Al-Yarmouk Teaching Hospital in Karkh, through which 1250 stool samples of different age groups were examined. Five groups of mice were used in the study; the first was injected with normal saline and considered as a negative control group, the second was injected with cystic form of non-irradiated Giardia lamblia and considered as a positive control group, whereas the other three groups were injected with gamma irradiated Giardia lamblia at three different doses 10, 15 and 25 rad respectively. Giardia lamblia was primarily cultivated in liver infusion agar for ten days to obtain the active phase. On the sixth day, the cystic phase was purified and standardized to be used in the infection of mice with or without the exposure of gamma rays. Mice showed high sensitivity to parasitic infestation, in the gamma non-irradiated and the irradiated with gamma 10 rad, and 15 rad irradiated groups which was 100%. The results expressed an excystation process of the depleted phases and the release of the feeder phases. The results of the three irradiated groups consisted of histopathological changes of the small, and the rectum by dissection after two weeks of infection, with intestine amputation lesions, as well as ulceration and inflammation of the inflammatory cells represented in small numbers of neutrophil, lymphocytes, and eosinophils. The presence of ulceration and fall of epithelial cells in the intestinal cavity has been shown, and different forms of the parasite have been observed. Mice which was injected with irradiated G lamblia at high dose (25 rad), not show and sensitivity to the challenge infection and no excystation of thy parasite had been done. After 2 wreaks, a comparison was achieved between all study groups in which no histopathological changes were noticed in the mice irradiated with dose of25 rad. After another two weeks, a challenge dose was given (un-attenuated G lamblia) and mice were dissected after another two weeks, no changes on the level of histopathology of intestinal tissue were noticed the results suggested that mice acquire an immunity against the parasite infection.

A STUDY ON THE VARIATION IN CA 72-4 LEVELS OF THE GASTRIC CANCER’S PATIENTS BEFORE AND AFTER SURGERY TREATMENT

2011 ◽  
pp. 81-87
Author(s):  
Thi Thu Huong Hoang ◽  
Minh Vuong Nguyen
Keyword(s):  
Gastric Cancer ◽  
Study Groups ◽  
University Hospital ◽  
Control Group ◽  
Central Hospital ◽  
Before And After

Objectives: Studying on the variation in CA 72-4 levels of the gastric cancer’s patients before and after 10 days and 30 days surgery treatment. Materials and methods: The studying group included 42 gastric cancer’s patients who were examinated and treated in cancerology service of Hue University Hospital and gastroenterology service of Hue Central Hospital. The control group included 30 healthy normal examinated at Hue University Hospital. The study groups were clinical, endoscopic anatopathologic examination diagnosed with gastric cancer and quantitative levels of CA 72-4 in three times points: before surgerying, after surgerying 10 days and 30 days postoperatively. Rerults: The concentration of CA 72-4 in gastric cancer’s patients was 10.06 ± 16.49 U/ml. Clearly higher than the control group 1.2 ± 0.4 U/ml(p <0.01). The rate increased levels of CA 72-4 in gastric cancer’s patients before surgerying was 27.5% and the control group was 0%. After 10 days of surgery, CA 72-4 level was 5.56 ± 8.55 U/ml; 82.5% of patients have reduced levels of CA 72-4 and 17.5% no changes; there are 0% increased cases. After 30 days of surgery, CA 72-4 level was 3.79 ± 6,52 U/ml. CA 72-4 level 10 days after surgering have decreased significantly compared to before surgery (p < 0.05) and 30 days after surgery have decreased significantly compared to after 10 days (p < 0.05). 30 days postoperatively, 90% patients had reduced levels of CA 72-4, 10% no changes, no patient had increased levels of CA 72-4 and no patient be relapsed after 30 days of treatment. Conclusions: CA 72-4 concentrations before surgerying increased 27.5%, after surgery 10 days and 30 days reduced step by step, no case have increased CA 72-4 levels, no case relapsed after 30 days.

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