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COX 2 selectivity of non-steroidal anti-inflammatory drugs and perioperative blood loss in hip surgery. A randomized comparison of indomethacin and meloxicam

Published online by Cambridge University Press:  11 July 2005

E. W. G. Weber ,
R. Slappendel ,
M. E. Durieux ,
R. Dirksen ,
H. van der Heide  and
M. Spruit
E. W. G. Weber
Affiliation:
University Hospital Maastricht, Department of Anesthesiology, Maastricht, The Netherlands
R. Slappendel
Affiliation:
Maartenskliniek, Nijmegen, The Netherlands
M. E. Durieux
Affiliation:
University Hospital Maastricht, Department of Anesthesiology, Maastricht, The Netherlands
R. Dirksen
Affiliation:
Maartenskliniek, Nijmegen, The Netherlands
H. van der Heide
Affiliation:
Maartenskliniek, Nijmegen, The Netherlands
M. Spruit
Affiliation:
Maartenskliniek, Nijmegen, The Netherlands
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Extract

Summary

Background: In this prospective randomized study we tested the hypothesis that use of more cyclo-oxygenase 2 (COX 2)-selective non-steroidal anti-inflammatory drugs (NSAIDs) can reduce perioperative blood loss compared with non-selective NSAIDs.

Methods: Data from 200 patients who underwent total hip replacement were studied. Two NSAIDs were compared: indomethacin 50 mg (n = 82) and meloxicam 15 mg (n = 86). Both NSAIDs were given orally 1 h before surgery.

Results: The two groups were not different with respect to age, gender, ASA class or duration of surgery. When indomethacin was used preoperatively, intraoperative blood loss was 623 ± 243 mL (mean ± SD) and postoperative blood loss 410 ± 340 mL. After meloxicam, these values were 524 ± 304 mL and 358 ± 272 mL, respectively. Total perioperative blood loss after meloxicam was 17% (P < 0.05) less than that observed after indomethacin.

Conclusion: Perioperative blood loss after meloxicam is less than after indomethacin. These in vivo findings are consistent with in vitro results using selective COX 2 NSAIDs.

Keywords

ANALGESICS, NON-NARCOTIC, anti-inflammatory agents, non-steroidalARTHROPLASTY, REPLACEMENT, HIPHAEMORRHAGE, blood loss, surgical
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 12 , December 2003 , pp. 963 - 966
Copyright
© 2003 European Society of Anaesthesiology

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