Abstract
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.
Publication types
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Clinical Trial
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Comparative Study
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Randomized Controlled Trial
MeSH terms
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Aged
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Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
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Anti-Inflammatory Agents, Non-Steroidal / blood
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Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
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Arthroplasty, Replacement, Hip*
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Blood Loss, Surgical / prevention & control*
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Cyclooxygenase 2
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Cyclooxygenase 2 Inhibitors
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Cyclooxygenase Inhibitors / administration & dosage
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Cyclooxygenase Inhibitors / blood
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Cyclooxygenase Inhibitors / pharmacology
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Female
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Humans
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Indomethacin / administration & dosage
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Indomethacin / blood
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Indomethacin / pharmacology*
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Isoenzymes / antagonists & inhibitors*
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Male
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Meloxicam
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Membrane Proteins
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Middle Aged
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Pain Measurement
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Pain, Postoperative / prevention & control
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Perioperative Care
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Prospective Studies
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Prostaglandin-Endoperoxide Synthases
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Thiazines / administration & dosage
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Thiazines / blood
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Thiazines / pharmacology*
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Thiazoles / administration & dosage
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Thiazoles / blood
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Thiazoles / pharmacology*
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Time Factors
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Cyclooxygenase 2 Inhibitors
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Cyclooxygenase Inhibitors
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Isoenzymes
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Membrane Proteins
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Thiazines
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Thiazoles
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Cyclooxygenase 2
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PTGS2 protein, human
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Prostaglandin-Endoperoxide Synthases
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Meloxicam
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Indomethacin