Anaesthetic management of emergency spine surgery with patient on dual antiplatelet agents

Abstract

Antiplatelet therapy plays an important role in the management of coronary artery disease (CAD) patients, which include the spectrum of patients with stents in situ and those suffering from acute coronary syndrome (ACS) on medical management. The percentage of patients with stents in situ, scheduled for surgery within 2 years, is approximately 5–15%. The antiplatelet therapy predisposes patients to an increased risk of bleeding in the perioperative region, which can lead to fatal outcomes in spinal or intracranial surgeries; the problem multiplies manifolds if the surgery has to be performed in an emergency situation. We report a case of a 76-year-old lady, a known case of CAD with drug eluting stent in situ, on dual antiplatelet agents who had presented to our hospital with progressive weakness of lower limbs and had to be operated on the spine in emergency situation.