Many people now take a small dose of aspirin every day or every second day to lessen their chances of getting a coronary heart attack. Aspirin helps them to do this by rendering their blood less capable of clotting (during most heart attacks, an artery in the heart that has become narrowed by deposits of cholesterol becomes completely blocked off by a clot of blood).
However, no drug, including aspirin, is without side effects of some sort, and in this case we need to be concerned that loss of clotting ability could be dangerous during surgery. In fact, Emergency Medicine (19#18:57) points out that aspirin significantly increases the incidence of complications due to blood loss after such procedures as tooth extraction, facial plastic surgery, tonsillectomy, and coronary artery bypass graft operations. Although less noticeable, this effect of aspirin could mar the result of any operation. Adequate clotting, of course, is necessary to seal off and stop oozing from blood vessels that are cut across during operations, even though they have been tied off by the surgeon.
To reduce this risk of postoperative bleeding as much as possible, aspirin should be discontinued for at least a week before surgery. When this is not possible, be sure the surgeon knows if you have been taking aspirin. He can then test the blood and decide whether something needs to be done to restore clotting to normal before he operates. Other medications that interfere with clotting include non-steroidal antiinflammatory drugs (NSAIDs) such as Advil, Clinoril, Feld-ene, Indocin, Motrin, Nalfon, Naprosyn, Nuprin, and Tol-ectin, which are used for arthritic pain, headache, and menstrual cramps, etc. Fish oil products, such as Maxepa, and vitamin E can do the same thing. Since several other drugs also have this effect, be sure to tell the surgeon about every medication that you are taking.
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