[Evaluation of the clinical efficacy of misoprostol for gastric cytoprotection in patients under treatment with NSAID after proctologic intervention].
To perform ambulatorial surgery with local anaesthetics, it is important to carry out a correct postsurgical NSAID therapy avoiding the risks induced by these drugs. Two groups of patients submitted to ambulatorial hemorrhoidectomy were enrolled in a randomized study to evaluate the safety of NSAID therapy with or without the coadministration of misoprostol, a PGE1 analogue with gastroprotective action. Aim of this study was to evaluate if misoprostol in coadministration with NSAID could permit a correct domiciliary postsurgical NSAID therapy without gastric symptoms related to the NSAID therapy. From January 1990 to December 1991, 95 patients underwent hemorrhoidectomy and were discharged with analgesic therapy: the first group (n = 45) without gastroprotective therapy, the second group (n = 50) with the coadministration of misoprostol 200 mcg bid. After 7 and 14 days of treatment patients showed the following symptoms: in the first group 13.3% of the cases showed mild epigastric pain, 8.8% moderate epigastric pain and 4.4% severe epigastric pain with heartburn; in the second group (NSAID + misoprostol) only 4% of the cases showed moderate epigastric pain. The incidence of epigastric pain was statistically higher (p < 0.05) in patients treated with NSAID alone in comparison with the group treated with NSAID + misoprostol. The results, according to international literature, show that correct gastro-protective therapy with synthetic prostaglandins (misoprostol) is necessary for patients in treatment with NSAIDs.
Spaggiari
L
L
Istituto di Clinica Chirurgica Generale, Toracica e Vascolare, Università degli Studi di Parma.
Carbognani
P
P
Rusca
M
M
Dell'Abate
P
P
Soliani
P
P
Anelli
D
D
Cattelani
L
L
Foggi
E
E
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000187:drug effects / Q000601:surgery; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005401:Fissure in Ano / Q000601:surgery*; D005753:Gastric Mucosa / Q000187:drug effects*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016595:Misoprostol
Valutazione dell'efficacia clinica della citoprotezione gastrica con misoprostol nei pazienti in trattamento con FANS dopo intervento proctologico.