Low-dose aspirin and clopidogrel: how to act in patients scheduled for day surgery

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.

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.

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.