Preemptive analgesia by lornoxicam--an NSAID--significantly inhibits perioperative platelet aggregation.
OBJECTIVE
To investigate whether preemptive administered lornoxicam changes perioperative platelet function during thoracic surgery.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Felfernig
M
M
Royal Medical Wing-Al Mafraq, Department of Anaesthesia and Intensive Care, Abu Dhabi, UAE. michael.felfernig@meduniwien.ac.at
Salat
A
A
Kimberger
O
O
Gradisek
P
P
Müller
M R
MR
Felfernig
D
D
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001780:Blood Coagulation Tests / Q000706:statistics & numerical data; D006801:Humans; D008171:Lung Diseases / Q000097:blood / Q000601:surgery; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care / Q000379:methods; D010894:Piroxicam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010974:Platelet Aggregation / Q000187:drug effects*; D011446:Prospective Studies; D003074:Solitary Pulmonary Nodule / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; C059451:lornoxicam