Clopidogrel 7-Day Rule Neuraxial — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

EasyRegional AnaesthesiaClopidogrel 7-Day Rule NeuraxialFRCA Final

A 72-year-old man (ASA III) requires a knee replacement. He had a bare-metal coronary stent inserted 8 weeks ago and is on aspirin and clopidogrel. The cardiologist says clopidogrel can be stopped at 4 weeks post-BMS. You plan a spinal anaesthetic. The minimum interval between stopping clopidogrel and performing a spinal is:

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — 7 days

Clopidogrel requires a 7-day washout before neuraxial techniques (Association of Anaesthetists 2013). The platelet lifespan is ~10 days; stopping clopidogrel for 7 days allows approximately 30% of the platelet pool to regenerate with normal function, which is sufficient for haemostasis. For bare-metal stents, the minimum duration of dual antiplatelet therapy before stopping one agent for surgery is 4 weeks (ESC/ESA 2022), so at 8 weeks post-BMS, clopidogrel can be safely stopped. Aspirin should be continued throughout.

Reference: Association of Anaesthetists – 2013 – Regional anaesthesia and coagulation; ESC/ESA – 2022