Perioperative Bridging Therapy

Abstract

Haemostasis, defined as arrest of bleeding, comes from Greek, haeme meaning blood and stasis meaning to stop .Hemostasis is the physiological process that stops bleeding at the site of an injury while maintaining normal blood flow elsewhere in the circulation (Gale, 2011). The stress response is the name given to the hormonal and metabolic changes which follow surgery or trauma. This is part of the systemic reaction to surgery which encompasses a wide range of endocrinological, immunological and haematological effects Hypercoagulable disorders are now diagnosed more frequently than before. These patients are, usually, managed with multiple anticoagulant and antiplatelet medications. Left unmonitored and unevaluated, there can be disastrous haemorrhagic or thrombotic complications. Appropriate perioperative and anaesthetic management of these patients will invite an aetiological diagnosis, severity analysis and the on-going treatment review. Bleeding and neuraxial haematomas can be disastrous complications at times. Associated low platelet count may need mo