Effect of indomethacin on postoperative protein metabolism after gastrectomy under total parenteral nutrition.
A randomized trial was undertaken to evaluate the effects of postoperative indomethacin (IDM) administration on protein metabolism in 20 patients who underwent an uncomplicated distal gastrectomy and were placed on post-operative total parenteral nutrition (TPN). Ten patients (the IDM group) received 50 mg of IDM every 8 h after operation up to postoperative day (POD) 4 while the other ten patients (the control group) received neither IDM nor any other non-steroidal anti-inflammatory drug, postoperatively. Though the requirement for postoperative plasma transfusion was significantly greater in the IDM group, the albumin level on POD 1 was significantly lower in this group than in the control group. The postoperative changes of C-reactive protein, retinol binding protein, and pre-albumin between the two groups showed no difference. Moreover, the urinary 3-methylhistidine excretion, N-balance, and plasma aminogram on POD 4 also demonstrated no difference. We thus concluded that post-operative IDM administration after elective surgery has no additional anti-catabolic effect on the presence of TPN.
Tsujinaka
T
T
Department of Surgery II, Osaka University Medical School, Japan.
Kido
Y
Y
Hayashida
Y
Y
Ogawa
A
A
Ishida
H
H
Homma
T
T
Iijima
S
S
Sakaue
M
M
Mori
T
T
D001798:Blood Proteins / Q000032:analysis; D001803:Blood Transfusion; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D008762:Methylhistidines / Q000652:urine; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011228:Prealbumin / Q000032:analysis; D011506:Proteins / Q000378:metabolism*; D012177:Retinol-Binding Proteins / Q000032:analysis; D054839:Retinol-Binding Proteins, Plasma; D012709:Serum Albumin / Q000032:analysis
D001798:Blood Proteins; D008762:Methylhistidines; D011228:Prealbumin; D011506:Proteins; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma; D012709:Serum Albumin; C028118:3-methylhistidine; D009584:Nitrogen; D007213:Indomethacin