British Journal of Anaesthesia, Vol 82, Issue 3 360-365, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
J. R. Sonksen, K. L. Kong and R. Holder
Aspirin ingestion within the previous 7-10 days is often considered a
relative contraindication to performing invasive procedures. However,
aspirin is an important component of many patients' treatment and
withholding therapy for this time may be dangerous. To measure both the
magnitude of the impairment in primary haemostasis induced by aspirin and
how much recovery of platelet function occurs within 48 h of stopping
aspirin, we studied serial changes in bleeding time (BT) in a randomized,
double-blind, placebo-controlled study. Fifty-two healthy volunteers had BT
performed before and at 2, 9, 24 and 48 h after a 7- day course of either
aspirin 75 mg, 300 mg or placebo. The main outcome recorded was BT at each
time. Nearly 25% of subjects had extended BT to more than 10 min, but no BT
were greater than 10 min, 48 h after stopping aspirin. There was a small
but statistically significant (P < 0.01) difference between the 48-h and
baseline BT in both aspirin groups (49 and 64 s in the 75 mg and 300 mg
groups, respectively). There was no difference in the magnitude or time
course of effect between low and medium dose aspirin (P = 0.392 and P =
0.797, respectively). We conclude that despite considerable
inter-individual variability in the magnitude of aspirin effect on primary
haemostasis, the time course of effect was consistent. In healthy
volunteers, the defect in primary haemostasis had largely disappeared 48 h
after the last dose.
CLINICAL INVESTIGATIONS
Magnitude and time course of impaired primary haemostasis after stopping chronic low and medium dose aspirin in healthy volunteers
Department of Anaesthesia, City Hospital, Dudley Road, Birmingham B18 7QH, UK
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