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

Eur J Anaesthesiol. 2003 Dec;20(12):963-6. doi: 10.1017/s0265021503001558.

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

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / blood
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
  • Arthroplasty, Replacement, Hip*
  • Blood Loss, Surgical / prevention & control*
  • Cyclooxygenase 2
  • Cyclooxygenase 2 Inhibitors
  • Cyclooxygenase Inhibitors / administration & dosage
  • Cyclooxygenase Inhibitors / blood
  • Cyclooxygenase Inhibitors / pharmacology
  • Female
  • Humans
  • Indomethacin / administration & dosage
  • Indomethacin / blood
  • Indomethacin / pharmacology*
  • Isoenzymes / antagonists & inhibitors*
  • Male
  • Meloxicam
  • Membrane Proteins
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / prevention & control
  • Perioperative Care
  • Prospective Studies
  • Prostaglandin-Endoperoxide Synthases
  • Thiazines / administration & dosage
  • Thiazines / blood
  • Thiazines / pharmacology*
  • Thiazoles / administration & dosage
  • Thiazoles / blood
  • Thiazoles / pharmacology*
  • Time Factors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2 Inhibitors
  • Cyclooxygenase Inhibitors
  • Isoenzymes
  • Membrane Proteins
  • Thiazines
  • Thiazoles
  • Cyclooxygenase 2
  • PTGS2 protein, human
  • Prostaglandin-Endoperoxide Synthases
  • Meloxicam
  • Indomethacin