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

• Published in: European journal of anaesthesiology Vol. 25; no. 9; p. 726
• Main Authors: Felfernig, M, Salat, A, Kimberger, O, Gradisek, P, Müller, M R, Felfernig, D
• Format: Journal Article
• Language: English
• Published: England 01.09.2008
• Subjects: Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Blood Coagulation Tests - statistics & numerical data; Humans; Lung Diseases - blood; Lung Diseases - surgery; Middle Aged; Pain, Postoperative - prevention & control; Perioperative Care - methods; Piroxicam - administration & dosage; Piroxicam - adverse effects; Piroxicam - analogs & derivatives; Platelet Aggregation - drug effects; Prospective Studies; Solitary Pulmonary Nodule - surgery; Time Factors; Treatment Outcome
• ISSN: 1365-2346
• DOI: 10.1017/S0265021508004274

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