Aggrenox

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climbingdocs

climbingdocs

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I am doing lobectomy tomorrow, patient would benefit from epidural but he is on Aggrenox. Anyone knows if there are ASRA guidelines for Aggrenox? I tried to look it up but no luck... thanks!
 
Go ahead and do it.
 
so it won't increase risk of hematoma? Apparently they are not going to D/C it at all....
 
Planktonmd said:
Really?
Why are you so sure?
I would stop the Aggrenox for 1-2 days, this will hopefully allow the Dipyridamole to be out of the picture and leave you only with the effect of Aspirin which should be OK.
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Because in Europe we did it a lot - as you know it was custom to have all the vascular patients on Dipyridamole.
I didn't have any problem. I am sure that is fine too to stop it - nothing will happen ...
 
2win said:
Because in Europe we did it a lot - as you know it was custom to have all the vascular patients on Dipyridamole.
I didn't have any problem. I am sure that is fine too to stop it - nothing will happen ...
Click to expand...

I can confirm this
 
I remember in France that every one was on Dipyridamole but at that time they were not combining it with Aspirin.
Are the Europeans giving combined Aspirin/Dipyridamole now? and are they routinely doing epidurals with that combination?
 
Planktonmd said:
I remember in France that every one was on Dipyridamole but at that time they were not combining it with Aspirin.
Are the Europeans giving combined Aspirin/Dipyridamole now? and are they routinely doing epidurals with that combination?
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Yes - we did it.
I don't have a study to asses the risk - this is based on my practice.
I'll check pubmed.
 
Aggrenox contains 25mg of salicylic acid so not enough to inhibit platelet function.
 
dhb said:
Aggrenox contains 25mg of salicylic acid so not enough to inhibit platelet function.
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No one knows wht dose of aspirin is "enough to inhibit platelet function".


Further, no one knows what a small dose of ASA combined with another platelet aggregation inhibitor would do.
 
Ok but you have two weak drugs combined which have not been related to a higher morbidity with neuraxial blocks
 
dhb said:
Ok but you have two weak drugs combined which have not been related to a higher morbidity with neuraxial blocks
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You are probably right, and If I were still practicing in France I would have agreed with you.
But, Unfortunately, I practice in the U.S. and this means that the right thing to do is what the majority of practitioners would do.
This is what lawyers call the "standard of care" and in this case it is not very clear.
 
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