Local and regional anaesthesia: aspirin and neuraxial block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local and regional anaesthesia: aspirin and neuraxial block

Sample item

A 70-year-old taking aspirin 75 mg daily alone for ischaemic heart disease is booked for transurethral resection under spinal anaesthesia. Platelet count and clotting tests are normal. What is the appropriate approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Proceed with the spinal as planned

Aspirin on its own does not significantly raise the risk of spinal haematoma, so a neuraxial block can go ahead when there is no other coagulation problem. Risk rises when aspirin is combined with other anticoagulants or antiplatelet drugs. Stopping it needlessly raises cardiac risk.

Option by option

  • A. Choose general anaesthesia only

    General anaesthesia is not required, and it would remove the benefits of regional technique.

  • B. Proceed with the spinal as planned (correct)

    Correct. Aspirin alone does not meaningfully add to haematoma risk after a neuraxial block.

  • C. Transfuse platelets before the block

    Platelet transfusion has its own risks and is not indicated with a normal count.

  • D. Postpone surgery for seven days off aspirin

    Stopping aspirin is unnecessary and exposes the patient to coronary events.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Proceed with the spinal as planned. Aspirin on its own does not significantly raise the risk of spinal haematoma, so a neuraxial block can go ahead when there is no other coagulation problem.

Why is "Choose general anaesthesia only" not the answer?

General anaesthesia is not required, and it would remove the benefits of regional technique.

Why is "Transfuse platelets before the block" not the answer?

Platelet transfusion has its own risks and is not indicated with a normal count.

Why is "Postpone surgery for seven days off aspirin" not the answer?

Stopping aspirin is unnecessary and exposes the patient to coronary events.

What concept does this question test?

It tests Local and regional anaesthesia: aspirin and neuraxial block in Anaesthesia. Risk rises when aspirin is combined with other anticoagulants or antiplatelet drugs. Stopping it needlessly raises cardiac risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: aspirin and neuraxial block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.