Alcohol and preoperative management.

Abstract

The French paradox is a recently coined term used to describe the lower incidence of heart disease in the French as compared with Americans in the face of increased cholesterol intake, higher serum cholesterol levels, and elevated blood pressures. The principal lifestyle factor explaining this paradox is alcohol intake. Research has shown that alcohol in general and wine in particular have myriad effects on the cardiovascular system--raising high-density lipoprotein levels, increasing antioxidant capabilities, and prolonging platelet aggregation. The most impressive benefits of alcohol appear to be platelet-related. Research has demonstrated an undeniable effect of alcohol on platelet function and bleeding characteristics. This information has been used recently to modify risk factors for heart disease; however, these data have a role in the preoperative management of surgical patients. In order to decrease the incidence and severity of intraoperative and postoperative bleeding, patients should be advised to abstain from alcohol and particularly red wine before surgery. In addition, alcohol has been found to have a synergistic effect with aspirin on bleeding times. These two substances, both individually and in combination, should be avoided preoperatively.