Stop ibuprofen the day before surgery?
A study of the effects of ibuprofen on platelet activity has concluded that it may be sufficient to stop ibuprofen on the day before surgery rather than one week ahead (Ann Intern Med 2005;142:506-9).

It's not unusual for surgeons to recommend stopping regular ibuprofen treatment one week before surgery to avoid the risk of bleeding complications - but there's no evidence to support this practice. US investigators have now studied the duration of platelet inhibition after discontinuing ibuprofen following a week's administration of 1,800 mg/day to health volunteers. (The usual dose of OTC ibuprofen is 200 - 400 mg three times daily.)

They measure platelet activity with a platelet function analyser, which records the time taken for platelets to aggregate after exposure to a membrane coated with collagen and adrenaline. This is denoted as the closure time; a value of 167 seconds is the threshold corresponding to abnormal platelet function.

Before taking ibuprofen, all participants had normal platelet function (median closure time 130 seconds). Forty minutes after taking the last dose of ibuprofen, median closure time was 225 seconds, though it was below the critical value of 167 in 4 of the volunteers. After 8 hours, median closure time was reduced to 138 seconds, with 7 participants now below the threshold for abnormality. After 24 hours, the median closure time had returned to baseline (120 seconds) and all participants were within the normal range.

The authors acknowledge that they did not measure actual bleeding time but they say their method is more accurate. They also found that oral contraceptive use mitigated the effects of ibuprofen on platelet activity.

Contact us
For more information.