New anticoagulants: perioperative considerations

During preoperative patient evaluation, anaesthesiologists assess the patient's bleeding history and risks for thrombosis and initiate individualized coagulation management. New potent anticoagulants may increase blood loss and the risk for spinal haematoma in patients scheduled for neuraxial anaesthesia. Postoperative start of thromboprophylaxis and recommendations on the timing of invasive interventions help in controlling these risks. Before widespread use for cardiological indications open questions need to be answered e.g. oral drug administration in postoperative vomiting and potential interactions with postoperative pain therapy.