Pre‐operative medication and proximal femoral fractures

Pre‐operative medication and proximal femoral fractures

“…Clopidogrel should be stopped on admission except in high-risk patients: bare metal stent insertion within 6 months; acute coronary syndrome or stroke within 6 weeks; and drug eluting stent insertion within 6-12 months [3,4,7]. In these situations, the decision to stop clopidogrel should be made in conjunction with a cardiologist or the prescribing practitioner.…”

Current BNF recommendations on peri‐operative cessation of clopidogrel

“…We read with interest the recent guidance on antiplatelet therapy in the new AAGBI guidelines on fractured neck of femur [1] and the ensuing correspondence on the peri-operative management of clopidogrel [2]. Currently, the British National Formulary (BNF) states that clopidogrel should be 'discontinue(d) 7 days before elective surgery if an antiplatelet effect not desirable' [3].…”

“…The differential diagnosis included intracranial haemorrhage or other space-occupying lesion causing oculomotor nerve compression, impaired venous return from the head, ocular trauma, ocular exposure to sympathomimetic or anticholinergic agents, and pre-existing ophthalmic conditions [2][3][4]. Surgical manipula-…”