Tehran University Medical Journal (Mar 2018)
Is it necessary to withdraw aspirin before non-cardiac surgeries?
Abstract
Background: The benefits of aspirin have been proven by repeated examinations, especially in secondary prevention in cardiac infarction, stroke, and after interventional angiography and stent insertion. Methods: This is a retrospective study on all patients who underwent non-cardiac surgeries between June 2005 and March 2013 in Ghaem hospital in Mashhad and aspirin continued due to many reasons. Most frequent surgeries included laparoscopic appendectomy and cholecystectomy. Information such as bleeding and its amount both during surgery and post-operative, hematoma after surgery, requiring re-operation due to bleeding and cardiovascular events in hospital were recorded and analyzed. Moreover, all patients were followed within one month after discharge from hospital to check whether any cardiovascular events had been happened. Furthermore, bruising in the skin, and bleeding after discharge were evaluated. Data were analyzed using SPSS Version 16 (SPSS, Chicago, IL, USA). Results: One hundred seventy patients enrolled in the study and all of them underwent general anesthesia. Of all patients 37.06% were male and 62.94% were female. The mean age was 52.78±5.01 years. Majority of operations included laparoscopic cholecystectomy (41.62%). Also in most of the patients (58.38%) surgery were emergency and discontinuation of aspirin were impossible. 91.37% of patients were taking less than 80 mg aspirin per day. Mean bleeding amount during surgery was 100 ml. 13 patients (6.59%) who undergo laparoscopic cholecystectomy and one patients in appendectomy group had bleeding more than 110 ml due to inadequate artery ligation and they underwent conversion to open surgery and bleeding were controlled successfully. Other eight patients (4.06%) treated conservatively without need to conversion to open surgery. In 7.61% of patients, ecchymosis happened which were healed within one month. No patient underwent reoperation due to post-operative hemorrhage. No vascular event and hematoma had been reported during one month follow up after surgery. Conclusion: Continuing aspirin in perioperative period of non-cardiac surgeries were without additional risk of bleeding and it also helped to reduce risk of vascular evets post-operatively.
