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Anaesthesia Preoperative assessment and monitoring in anaesthesia 40596a5c

A 59-year-old man is planning to undergo a coronary aery bypass. He has osteoahritis and consumes nonsteroidal anti-inflammatory drugs (NSAIDs) for the pain. Which of the following is the most appropriate treatment prior to surgery to minimize his risk of bleeding from his NSAID use?

A
Begin vitamin K 1 week prior to surgery.
B
Give FFP few hours before surgery
C
Stop the NSAIDs 1 week prior to surgery.
D
Stop the NSAIDs 3 to 4 days prior to surgery.
High-Yield Explanation
NSAIDs such as aspirin block platelet function by causing a reversible defect in the enzyme cyclooxygenase. Unlike aspirin which permanently acetylates cyclooxygenase and leaves affected platelets dysfunctional throughout their 7-day life span, NSAIDs cause a reversible defect that lasts 3 to 4 days. Therefore, the patient's platelets will be functional for surgery if he stops taking the NSAIDs 3 to 4 days prior to the date of surgery. The patient would not benefit from FFP or vitamin K since he does not have problems with his clotting factors.

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