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?
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.
Begin vitamin K 1 week prior to surgery.
Give FFP few hours before surgery
Stop the NSAIDs 1 week prior to surgery.
Stop the NSAIDs 3 to 4 days prior to surgery.
Preoperative assessment and monitoring in anaesthesia