ecosprine and anaesthesia

Started by kalpesh shah, June 16, 2009, 07:43:27 AM

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kalpesh shah

Hi, please coment on this case.
50 year old male pt with DM since 10 yr., on OHA since then, regular and controlled. no other medical illeness.
had mild chest disscomfort 6 month back, investiged by MD physicion in remote place, starte with ecosprine, since then taking it regularly, no problem after that.(angiography not done).
posted for removal of sub dental cysts(two moderat cyst below left molar and cannine).
ecosprine stoped since 15 days, CBC, HBSag, HIV, SUGAR, ECG are normal on the day of the surgery.
Taken 4 surger with nasal intubation, intraop hemodynamics were normal. af 1 hr of surgery pt extubated. 3 min af extubation pt has profuse bleeding.reintubated with great difficulties, but hematoma below the tongue in midline, which is reexplored and drained.for saftey tight nasal packing done. BTCT AND PT INR send. PT WAS 24 SEC AND INR was 21.1. pt managed with 4 units of FFP.bleeding stoped. PT came normal af 6 hrs.in retrospactive history nothing significant fount like any other medicine, or childhood trauma bleedig history.
any role of ecosprine? any guielines for pre op investigation?
medicolegal issues?

yogenbhatt1

#1
A hematoma under the tongue after the surgery is over. But then why was the nose packed? You should have packed some thing else, if at all.
You have mentioned INR as 21.1. I wonder if you evwen get this picture( Must be writing error, I hope) It will be criminal to operate at this level, if right.
Ecospirine??? every one wants to blame this tiny tablet for any thing that bleeds. It was stopped for over 15 days and all reports are normal, then why even think of it?
Latest is, not to stop ecospirine or clopido etc even on the day of surgery.
I think that the bleeding took place form some lingual vessal during surgery.
Do not hurt our cardio friends on ecospirine issue.
Regards, I love to read all your cases, they are full of life.