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Antiplatelet therapy in ENT surgery: a review

Published online by Cambridge University Press:  19 December 2011

D C Sylvester  and
A P Coatesworth
D C Sylvester*
Affiliation:
Department of Otolaryngology, York Hospital, UK
A P Coatesworth
Affiliation:
Department of Otolaryngology, York Hospital, UK
*
Address for correspondence: Miss D C Sylvester, Department of Otolaryngology, York Hospital, York YO31 8HE, UK Fax: +44 (0)1904 726346 E-mail: dsylvester@doctors.net.uk
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Abstract

Introduction:

Antiplatelet agents such as aspirin and clopidogrel are increasingly encountered in clinical practice. Otorhinolaryngological surgeons are involved in the peri-operative decision of whether to continue treatment and risk haemorrhage or to discontinue treatment and risk thrombosis.

Methods:

Literature relating to the risk of spontaneous or operative haemorrhage was reviewed. The morbidity and mortality associated with cessation of agents was evaluated. Published guidelines were also evaluated. A protocol for the management of antiplatelet agents in the peri-operative period, with particular reference to ENT operations, is presented.

Conclusion:

Significant morbidity and mortality is associated with the premature cessation of antiplatelet agents. Data from cardiac surgery suggest that operative blood loss only marginally increases in patients on aspirin and clopidogrel. However, the management of antiplatelet agents in the peri-operative period should be made after multidisciplinary consultation.

Keywords

Anti-platelet AgentsAspirinClopidogrelHaemorrhagePerioperative PeriodThrombosis
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 331 - 336
Copyright
Copyright © JLO (1984) Limited 2011

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