Effect of rofecoxib on platelet aggregation and blood loss in gynaecological and breast surgery compared with diclofenac

Details

Ressource 1Download: serval:BIB_2D609E076BF3.P001 (109.67 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_2D609E076BF3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of rofecoxib on platelet aggregation and blood loss in gynaecological and breast surgery compared with diclofenac
Journal
British Journal of Anaesthesia
Author(s)
Hegi T.R., Bombeli T., Seifert B., Baumann P.C., Haller U., Zalunardo M.P., Pasch T., Spahn D.R.
ISSN
0007-0912 (Print)
ISSN-L
0007-0912
Publication state
Published
Issued date
2004
Volume
92
Number
4
Pages
523-531
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Non-selective cyclooxygenase (COX) inhibitors or non-steroidal anti- inflammatory drugs (NSAIDs) are frequently omitted for perioperative pain relief because of potential side-effects. COX-2-selective inhibitors may have a more favourable side-effect profile. This study tested the hypothesis that the COX-2-selective inhibitor rofecoxib has less influence on platelet function than the NSAID diclofenac in gynaecological surgery. In addition, analgesic efficacy and side-effects of the two drugs were compared.
METHODS: In this single-centre, prospective, double-blind, active controlled study, women undergoing vaginal hysterectomy (n=25) or breast surgery (n=25) under general anaesthesia received preoperatively 50 mg of rofecoxib p.o. followed 8 and 16 h later by two doses of placebo or three doses of diclofenac 50 mg p.o. at the same time points. We assessed arachidonic acid-stimulated platelet aggregation before and 4 h after the first dose of study medication, estimated intraoperative blood loss, and haemoglobin loss until the first morning after surgery. Analgesic efficacy, use of rescue analgesics, and side-effects were also recorded.
RESULTS: In the rofecoxib group, stimulated platelet aggregation was disturbed less (P=0.02), and estimated intraoperative blood loss (P=0.01) and the decrease in haemoglobin were lower (P=0.01). At similar pain ratings, the use of anti-emetic drugs was less in the rofecoxib group (P=0.03).
CONCLUSION: Besides having a smaller effect on platelet aggregation, one oral dose of rofecoxib 50 mg given before surgery provided postoperative analgesia similar to that given by three doses of diclofenac 50 mg and was associated with less use of anti-emetics and less surgical blood loss in gynaecological surgery compared with diclofenac.
Keywords
Analgesics, Opioid/therapeutic use, Anti-Inflammatory Agents, Non-Steroidal/pharmacology, Antiemetics/therapeutic use, Blood Loss, Surgical/prevention & control, Breast Neoplasms/surgery, Cyclooxygenase Inhibitors/pharmacology, Diclofenac/pharmacology, Hemostasis, Surgical/methods, Lactones/pharmacology, Morphine/therapeutic use, Platelet Aggregation/drug effects
Pubmed
Web of science
Open Access
Yes
Create date
13/07/2018 9:00
Last modification date
01/10/2019 6:17
Usage data