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PERIOPERATIVE ANTICOAGULATION IN LOCAL ANAESTHETIC PROCEDURES FOR CUTANEOUS LESIONS
Author(s) -
Yang A. S.,
Moaveni Z.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04927_39.x
Subject(s) - medicine , clopidogrel , warfarin , aspirin , local anaesthetic , perioperative , discontinuation , surgery , general anaesthetic , anesthesia , general surgery , general anaesthesia , atrial fibrillation
Patients on long‐term aspirin and warfarin are not infrequently encountered in local anaesthetic cutaneous surgeries, which could potentially give rise to bleeding related problems post operatively. Encounters with a newer generation of antiplatelets, such as clopidogrel, may also become more prevalent with their use in cardiology and following endovascular procedures. While recommendations from studies in timing or even the need for preoperative discontinuation of aspirin in local anaesthetic procedures have been numerous, they continue to be questioned and the practices can vary significantly from surgeon to surgeon. The study is designed to retrospectively review peri‐operative management for aspirin, warfarin, and clopidogrel in the local anaesthetic cutaneous surgical cases performed at Waikato Hospital Plastic and Reconstructive Surgery Unit, and to gauge their impact on post‐operative complications. Case records from the plastic surgery local anaesthetic operating unit and clinics between January and December 2008 are reviewed. Information on the management of long‐term aspirin, warfarin and clopidogrel are gathered along with other significant co‐morbidities and coagulopathies, the type of surgical procedure, and significant complications necessitating further interventions in the hospital. We wish to report our experiences in Waikato Hospital on the management of aspirin, warfarin and clopidogrel peri‐operatively for local anaesthetic cutaneous procedures and their impact on complications with comparisons to findings in the available literatures.