Low-dose aspirin and clopidogrel: how to act in patients scheduled for day surgery.
OBJECTIVE
With the increasing use of antiplatelet drug treatment, complications resulting from its interference with invasive procedures (surgery or regional anaesthesia) have become an everyday challenge to the surgical team. The purpose of this review is to examine the most recent findings and integrate them into the ambulatory surgery setting.


RESULTS
Recent studies have outlined the risks of withholding antiplatelet drug treatment, but it is now generally considered to be preferable to withhold treatment than to maintain it. The role of low molecular weight heparins or short-life NSAIDs as bridge drugs is now discussed and their usefulness challenged.


CONCLUSIONS
Most ambulatory surgical procedures present low bleeding risk. The current attitude in this setting is to maintain aspirin therapy and possible antiplatelet drug inhibitors throughout the perioperative period. High-risk patients proposed for high-risk surgery should not be treated as outpatients.
Servin
Frédérique
F
Department of Anaesthesia and Intensive Care, Bichat Hospital, Paris, France. fservin@magic.fr
D000758:Anesthesia; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D000077144:Clopidogrel; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D017410:Practice Guidelines as Topic / Q000592:standards; D018570:Risk Assessment; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin