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

Author(s): Felfernig M, Salat A, Kimberger O, Gradisek P, Muller MR, Felfernig D

Affiliation(s): Royal Medical Wing-Al Mafraq, Department of Anaesthesia and Intensive Care, Abu Dhabi, UAE. michael.felfernig@meduniwien.ac.at

Publication date & source: 2008-09, Eur J Anaesthesiol., 25(9):726-31. Epub 2008 May 12.

Publication type: Randomized Controlled Trial

BACKGROUND AND 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. CONCLUSION: 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.