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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 ,
A. Salat ,
O. Kimberger ,
P. Gradisek ,
M. R. Müller  and
D. Felfernig
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: michael.felfernig@meduniwien.ac.at; 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.

Keywords

PLATELET AGGREGATIONANALGESIA POSTOPERATIVELORNOXICAM
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 9 , September 2008 , pp. 726 - 731
Copyright
Copyright © European Society of Anaesthesiology 2008

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