Our anaesthetists prefer to stop Aspirin 3-5 days and Clopidogrel 5-7 days before the schedule Orthopaedic surgery under regional (spinal/epidural) anaesthesia

Perioperative Management of Patients on Antiplatelet Therapy:

1. Patients with coronary stents:

        Elective surgery postponed for the following durations if aspirin and thienopyridine (eg, clopidogrel) therapy must be discontinued-

                                 Bare metal stents: 4-6 wk

                                 Drug-eluting stents: 12 months

       If surgery cannot be postponed, continue aspirin throughout perioperative period

2. Patients at high risk for cardiac events (exclusive of coronary stents):

                                Continue aspirin throughout the perioperative period

                                Discontinue clopidogrel at least 5 d (and preferably 10 d) before surgery

                                Resume clopidogrel 24 hrs postoperatively

3. Patients at low risk of cardiac events:

                              Discontinue antiplatelet therapy 7Y10 d before surgery

                              Resume antiplatelet therapy 24 hrs postoperatively

Adapted from ASRA guidelines on "Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy".