Patients taking aspirin (acetylsalicylic acid) undergoing surgical procedures require special attention due to the complexities involved. Whether due to the necessity of aspirin for cardiovascular conditions or the risks associated with the surgical act, preoperative assessment becomes crucial.
What is Aspirin (AAS):
Aspirin, or acetylsalicylic acid (AAS), is a widely used nonsteroidal anti-inflammatory drug (NSAID). In addition to its analgesic and anti-inflammatory properties, it stands out for its antiplatelet action, playing a fundamental role in cardiovascular conditions such as atherosclerosis and prevention of thrombotic events.
Clinical Indications:
Indications for the use of aspirin range from cardiovascular diseases to primary and secondary prevention of thrombotic events. Its relevance is undeniable, but it poses challenges in surgical procedures, especially regarding the risk of intraoperative bleeding.
Surgical Risks:
Surgical procedures in patients using aspirin are not without risks. Increased bleeding is a concern, and precise strategies to deal with this challenge are essential. Thorough assessment of the bleeding profile and surgical planning are imperative.
Anesthetic Risks:
Especially in spinal and epidural anesthesia, aspirin presents additional implications. The interaction between the medication and anesthesia components requires a careful approach to avoid complications. Pre-anesthetic assessment is fundamental in these scenarios.
Cost-Benefit of Prior Suspension:
The decision to suspend aspirin before surgery should be considered. Evaluating the balance between the cardiovascular risk associated with suspension and the risk of bleeding is a challenge. Individualized strategies, considering the nature of the surgery and the patient’s clinical status, are crucial.
Importance of Preoperative Assessment:
Given the challenges, preoperative assessment takes center stage. Understanding the patient in their entirety, considering the clinical context, is the foundation for informed decisions. Integration between the surgeon, anesthesiologist, and cardiologist is essential in this process.
Conclusion:
In surgeries involving patients taking aspirin, preventing complications requires a multidisciplinary approach. Detailed assessment, understanding the indications for aspirin, and personalization of the therapeutic plan are essential to ensure the safety and efficacy of the procedure. Ultimately, science and collaboration between specialties guide the path to successful interventions.
