Today, we revisit a topic that was recommended to us by Dr David Tragen of the Sunshine Coast University Hospital - the perioperative management of the direct oral anticoagulant medications or DOACs.

We start with some basic revision of the mechanism of action of the DOACs and their indications before diving more closely into the recommendations for stopping and starting these medications around the time of surgery, and the implications for our anaesthetic.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Resources for today's episode:

2021 ANZCA Blue Book: Direct Acting Oral Anticoagulants - pharmacology and perioperative considerations by Dr Kate Drummond (p147)

TGA Website

RE-ALIGN Trial

GALILEO Trial

BMJ: Coagulation assessment with the new generation of oral anticoagulants by  Charles Pollack Jr

Journal of Thrombosis and Haemostasis: Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians by J. Douxfils et al.

PAUSE Trial

Regional Anesthesia and Acute Pain: Regional anaesthesia in the patient receiving antithrombotic or thrombolytic therapy, 5th edition (ASRA 2025 Guidelines)

RE-VERSE-AD Trial

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!