Does low-dose aspirin increase blood loss after spinal fusion surgery?

Kang, Suk-Bong; Cho, Kyu Jung; Moon, Kyung-Ho; Jung, Jaehoon; Jung, Sin‐Ho

doi:10.1016/j.spinee.2011.02.006

Cited by 53 publications

(45 citation statements)

References 18 publications

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“…Relationships between NSAID administration and development of perioperative complications, including hemorrhage and hypotension, have been reported in people having elective surgical procedures, including spinal fusions. 27,28 Also, there is evidence in people that NSAIDS may adversely affect bone healing after spinal fusion in a dose-dependent manner, which could have implications regarding stability and potential for vertebral fusion after VSD. 29 Because of the retrospective nature of our study it was not possible to further characterize the influence of individual NSAIDs or dosing protocols, as a variety of different NSAID agents, doses, and duration of therapies were prescribed.…”

Section: Discussionmentioning

confidence: 99%

Acute adverse events associated with ventral slot decompression in 546 dogs with cervical intervertebral disc disease

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Acute adverse events associated with ventral slot decompression in 546 dogs with cervical intervertebral disc disease

et al. 2013

View full text Add to dashboard Cite

show abstract

“…[147][148][149][150][151][152] Furthermore, the use of low-dose ASA before spine surgery, even when discontinued for at least 7 days, has been suggested to lead to further blood drainage after surgery. 153 In an extensive review, low-dose ASA has also been shown to increase the rate of bleeding complications by a factor of 1.5 (median; interquartile range, 1.0-2.5). 94 The baseline risk of bleeding varied based on surgical type (cataract surgery vs transurethral prostatectomy).…”

Section: Procedural Recommendations: Overviewmentioning

confidence: 99%

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition)

Narouze

Benzon

Provenzano³

et al. 2017

Regional Anesthesia and Pain Medicine

118

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The American Society of Regional Anesthesia and Pain Medicine (ASRA) 2012 survey of meeting attendees showed that existing ASRA anticoagulation guidelines for regional anesthesia were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors required separate guidelines for pain and spine procedures. In response, a guidelines committee was formed. After preliminary review of published complications reports and studies, the committee stratified interventional spine and pain procedures according to potential bleeding risk: low-, intermediate-, and high-risk procedures. The ASRA regional anesthesia anticoagulation guidelines were largely deemed appropriate for the low- and intermediate-risk categories, but the high-risk category required further investigation. The first guidelines specific to interventional spine and pain procedures were published in 2015. Recent reviews evaluating bleeding complications in patients undergoing specific interventional pain procedures, the development of new regional anesthesia and acute pain guidelines, and the development of new anticoagulants and antiplatelet medications necessitate complementary updated guidelines. The authors desired coordination with the authors of the recently updated regional and acute pain anticoagulation guidelines. The latest evidence was sought through extensive database search strategies and the recommendations were evidence based when available and pharmacology driven otherwise. We could not provide strength and grading of these recommendations because there are not enough well-designed large studies concerning interventional pain procedures to support such grading. Although the guidelines could not always be based on randomized studies or on large numbers of patients from pooled databases, it is hoped that they will provide sound recommendations and the evidentiary basis for such recommendations. This publication is intended as a living document to be updated periodically with consideration of new evidence.

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“…[131][132][133][134][135][136] Furthermore, low-dose aspirin utilization before spine surgery, even when discontinued for at least 7 days, has been suggested to lead to further blood drainage after surgery. 137 In an extensive review, low-dose aspirin has also been shown to increase the rate of bleeding complications by a factor of 1.5 (median, interquartile range: 1.0-2.5). 88 The baseline risk of bleeding varied based on surgical type (cataract surgery vs transurethral prostatectomy).…”

Section: Procedural Recommendationsmentioning

confidence: 99%

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

Narouze

Benzon

Provenzano³

et al. 2015

Regional Anesthesia and Pain Medicine

266

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Interventional spine and pain procedures cover a far broader spectrum than those for regional anesthesia, reflecting diverse targets and goals. When surveyed, interventional pain and spine physicians attending the American Society of Regional Anesthesia and Pain Medicine (ASRA) 11th Annual Pain Medicine Meeting exhorted that existing ASRA guidelines for regional anesthesia in patients on antiplatelet and anticoagulant medications were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors necessitated separate guidelines for pain and spine procedures. In response, ASRA formed a guidelines committee. After preliminary review of published complication reports and studies, committee members stratified interventional spine and pain procedures according to potential bleeding risk as low-, intermediate-, and high-risk procedures. The ASRA guidelines were deemed largely appropriate for the low- and intermediate-risk categories, but it was agreed that the high-risk targets required an intensive look at issues specific to patient safety and optimal outcomes in pain medicine. The latest evidence was sought through extensive database search strategies and the recommendations were evidence-based when available and pharmacology-driven otherwise. We could not provide strength and grading of these recommendations as there are not enough well-designed large studies concerning interventional pain procedures to support such grading. Although the guidelines could not always be based on randomized studies or on large numbers of patients from pooled databases, it is hoped that they will provide sound recommendations and the evidentiary basis for such recommendations.

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Does low-dose aspirin increase blood loss after spinal fusion surgery?

Cited by 53 publications

References 18 publications

Acute adverse events associated with ventral slot decompression in 546 dogs with cervical intervertebral disc disease

Acute adverse events associated with ventral slot decompression in 546 dogs with cervical intervertebral disc disease

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition)

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

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