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Preemptive analgesia by lornoxicam – an NSAID – significantly inhibits perioperative platelet aggregation

Published online by Cambridge University Press:  01 September 2008

M. Felfernig*
Affiliation:
Royal Medical Wing-Al Mafraq, Department of Anaesthesia and Intensive Care, Abu Dhabi, UAE Medical University Vienna, Department of Anaesthesiology and Intensive Care Medicine, Vienna, Austria
A. Salat
Affiliation:
Medical University Vienna, Department of General Surgery, Vienna, Austria
O. Kimberger
Affiliation:
Medical University Vienna, Department of Anaesthesiology and Intensive Care Medicine, Vienna, Austria
P. Gradisek
Affiliation:
University of Ljubljana, Department of Anaesthesiology and Intensive Therapy, Slovenia
M. R. Müller
Affiliation:
Medical University Vienna, Department of Cardiothoracic Surgery, Vienna, Austria
D. Felfernig
Affiliation:
Medical University Vienna, Department of Anaesthesiology and Intensive Care Medicine, Vienna, Austria
*
Correspondence to: Michael Felfernig, Department of Anaesthesia and Intensive Care, RMW-Al Mafraq, Abu Dhabi, UAE. E-mail: [email protected]; Tel: +971 501248029; Fax: +971 25823763
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Summary

Background and objective

To investigate whether preemptive administered lornoxicam changes perioperative platelet function during thoracic surgery.

Methods

A total of 20 patients scheduled for elective thoracic surgery were randomly assigned to receive either lornoxicam (16 mg, i.v.; n = 10) or placebo (n = 10) preoperatively. All patients underwent treatment of solitary lung metastasis and denied any antiplatelet medication within the past 2 weeks. Blood samples were drawn via an arterial catheter directly into silicone-coated Vacutainer tubes containing 0.5 mL of 0.129 M buffered sodium citrate 3.8% before, 15 min, 4 h and 8 h after the study medication was administered. Platelet aggregation curves were obtained by whole blood electrical impedance aggregometry (Chrono Log®).

Results

Platelet aggregation was significantly reduced 15 min, 4 h and 8 h after lornoxicam administration compared to placebo (P < 0.05) for collagen, adenosine diphosphate and arachidonic acid as trigger substances. Adenosine diphosphate-induced platelet aggregation decreased by 85% 15 min after lornoxicam administration, and remained impaired for 8 h.

Conclusion

Platelet aggregation assays are impaired for at least 8 h after lornoxicam application. Therefore perioperative analgesia by use of lornoxicam should be carefully administered under consideration of subsequent platelet dysfunction.

Type
Original Article
Copyright
Copyright © European Society of Anaesthesiology 2008

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