Should Patients Undergoing Surgery Get ASA?

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Should Patients Undergoing Surgery Get ASA?

http://www.medicalnewstoday.com/medicalnews.php?newsid=54919

A national survey of Canadian surgeons by researchers at McMaster

University found little consistency in their use of the blood

thinner ASA in patients undergoing non-cardiac surgery.

To resolve the issue, Canadian surgeons say they would welcome a

randomized controlled trial, and allow their patients to participate

in it, said Dr. Rajesh Hiralal, who led the survey and is presented

its results 23 Oct 2006 in Vancouver at the annual meeting of the

Canadian Society of Cardiac Surgeons.

The findings are significant because non-cardiac surgery, such as

hip replacements and cancer surgery, makes up 95 per cent of all

surgery performed today and the numbers are growing. Cardiac surgery

accounts for less than five per cent.

Close to 100 million adults world-wide - and half a million

Canadians - undergoes major non-cardiac surgery annually. Globally,

upwards of one million of these patients go on to suffer a non-fatal

heart attack, non-fatal cardiac arrest or death as a result of their

surgery, said Dr. Hiralal.

" One of the great tragedies is that despite the advances we've had

in surgeries and anaesthesia, we have people potentially getting

cures of their cancer, or a new hip, with a new lease on life, who

either may die around the time of surgery because of heart

complications or they may have a non-fatal event which can actually

take their life three to six months later, " said Dr. P.J. Devereaux,

one of 15 McMaster researchers who undertook the survey.

As a blood thinner, ASA provides potential protection from the

development of blood clots following surgery. However, most studies

on its use have been conducted on patients undergoing cardiac

surgery. There has never been a large trial to address whether or

not ASA is effective for non-cardiac surgery.

To get a reading on current practices around the use of ASA,

McMaster researchers sent a questionnaire to 1,850 Canadian surgeons

who are members of the Canadian Orthopedic Association, the Canadian

Association of General Surgeons and the Canadian Society of Vascular

Surgery. More than 900 responded.

They found " marked variability " in practice between the three

surgical specialties.

" Among surgeons in general there is a lot of practice variation in

how they are managing ASA at the time of surgery, " said Dr.

Devereaux. " They are doing very different things and there is no

consistency. They are uncertain if there is a real benefit and if

that benefit outweighs the risk, even if there is, in fact, a risk. "