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Clopidogrel Hip Fracture Anaesthesia — FRCA Final MCQ

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HardTrauma & Emergency AnaesthesiaClopidogrel Hip Fracture AnaesthesiaFRCA Final

An 80-year-old woman (ASA III) falls and sustains an intracapsular fractured neck of femur. She takes clopidogrel 75 mg daily for a previous stroke. Surgery should occur within 36 hours (NICE NG111). Which anaesthetic technique is most appropriate?

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Correct answer: E — Fascia iliaca block and general anaesthesia

Clopidogrel requires a 7-day washout before neuraxial techniques (Association of Anaesthetists guidelines). Since NICE NG111 mandates surgery within 36 hours, waiting 7 days is not acceptable. General anaesthesia combined with a fascia iliaca block (not neuraxial) provides analgesia and avoids neuraxial risk. The fascia iliaca compartment is a compressible site, making it safe with antiplatelet therapy. Aspirin alone at standard dose does not contraindicate neuraxial blockade.

Reference: NICE – 2023 – NG111 Hip fracture; Association of Anaesthetists – 2013 – Coagulation and regional anaesthesia