title: Aspirin in the perioperative period: a review of the recent literature.
abstract: OBJECTIVE
  The indications for aspirin (ASA) for both primary and secondary prevention of thrombotic events continue to evolve. We review some of these indications and the recent literature regarding the perioperative administration of ASA.
  
  
  RESULTS
  ASA for primary prevention of cardiac ischemia, stroke, cancer, and death remains controversial. When used for primary prevention, ASA may be safely discontinued perioperatively. Patients with coronary or carotid artery stents should continue to receive ASA perioperatively. For patients with ischemic heart disease currently receiving ASA for secondary prevention of cardiac ischemia and stroke undergoing general surgery, orthopedic surgery, ophthalmological surgery, cardiovascular surgery, major vascular surgery, or a urological procedure, continuation of ASA is probably well tolerated, but further study is required. There is no indication to initiate ASA perioperatively in patients with stable ischemic heart disease as the risks outweigh the benefits. Until further data become available, decisions regarding the perioperative continuation of ASA should be made on a case-by-case risk-benefit analysis.
  
  
  CONCLUSIONS
  The continuation or discontinuation of ASA perioperatively remains a complicated issue. Further, well designed trials are needed for additional clarification.
authors.affiliation: Departments of Critical Care Medicine, Anesthesiology, and Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Mathew B
authors.initials: MB
authors.lastname: Kiberd
authors.forename: Richard I
authors.initials: RI
authors.lastname: Hall
mesh_terms: D001241:Aspirin / Q000627:therapeutic use*; D004347:Drug Interactions; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods*; D059035:Perioperative Period; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D013923:Thromboembolism / Q000517:prevention & control*
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin