Does ibuprofen increase perioperative blood loss during hip arthroplasty?

Thomas²,

et al. 2014

JCDR

Aim: To evaluate and compare the clinical effects of ibuprofen and diclofenac sodium on bleeding during periodontal surgery. Materials and Methods:Thirteen medically healthy men and women of mean age 37.5±17.67 (mean age± standard deviation) were selected for the study. All the subjects were divided into three groups: control (C) and test groups (T1) and (T2). Each subject of T1 group and T2 group was given ibuprofen and diclofenac sodium respectively, prior to surgery. Bleeding times of patients were recorded prior to performance of periodontal flap surgical procedures.Results: It was found that there was increased bleeding time and increased peri-operative bleeding when ibuprofen and diclofenac sodium were taken prior to surgery and this was statistically significant. (2.5538 (T1), 1.8385 (T2) versus 1.2385 (C) minute, p= .001) (mean blood loss) and (62.0325 ± 9.0594 (T1), 51.082 ± 9.792 (T2) versus 37.4992 ± 5.99 (C) millilitre, p = .000). Conclusion:The findings of this study suggested that preoperative administration of ibuprofen and diclofenac sodium could increase bleeding time and peri -operative blood loss.

Section: Discussionsupporting

confidence: 80%

NSAIDs and Bleeding in Periodontal Surgery

Thomas²,

et al. 2014

JCDR

Pathophysiol Haemos Thromb

“…As a first step, the findings in the hip and knee groups were pooled and adjudicated bleeding events, defined as severe and non-severe, were combined to give a total bleeding rate. The bleeding rate was calculated for three treatment groups, defined by the type and timing of prophylaxis [enoxaparin-treated patients; all melagatran/ximelagatrantreated patients (melagatran/ximelagatran [4][5][6][7][8][9][10][11][12] ), and melagatran/ ximelagatran-treated patients with initiation of treatment in the 4-to 8-hour period after surgery (melagatran/ximelagatran [4][5][6][7][8] )] and analyzed with respect to concomitant treatment (NSAIDs and/or ASA). Other parameters related to bleeding (peri-and postoperative blood loss, transfusion volumes and change in hemoglobin) were also calculated for the different treatment groups and analyzed with respect to concomitant treatment (NSAIDs and/or ASA).…”

Section: Methodsmentioning

confidence: 99%

“…Perioperative orthopedic surgical management includes the provision of pharmacological prophylaxis for the prevention of venous thromboembolism [2] . As ASA and NSAIDs may prolong bleeding times by altering normal hemostasis via platelet-specific mechanisms, their concomitant use with thromboprophylaxis may increase perioperative bleeding [3][4][5] . This has been borne out in 429 other indications, such as the treatment of acute coronary syndromes, with concomitant NSAIDs/antiplatelet agents shown to increase arterial bleeding side effects when administered with heparin [6] .…”

Section: Introductionmentioning

confidence: 99%

Assessment of Bleeding after Concomitant Administration of Antiplatelet and Anticoagulant Agents in Lower Limb Arthroplasty

Dahl

Ögren²,

Agnelli³

et al. 2006

In an analysis of the Melagatran Thrombosis Prophylaxis in Orthopedic Surgery (METHRO) III study, we evaluated whether concomitant administration of aspirin (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) with the direct thrombin inhibitor melagatran/ximelagatran or the low-molecular-weight heparin enoxaparin increased bleeding in patients undergoing major joint surgery. Further objectives were to compare the influence of the timing of initial postoperative administration of melagatran/ximelagatran on bleeding in orthopedic patients receiving ASA/NSAIDs and in comparison with the preoperative administration of enoxaparin. ASA or NSAIDs in conjunction with melagatran/ximelagatran or enoxaparin did not increase bleeding. Bleeding rates were not significantly different, irrespective of the timing of the initial postoperative dose of melagatran/ximelagatran (4–8 vs. 4–12 h) when compared with preoperative (12 h) administration of enoxaparin. Transfusion rates were significantly lower with administration of melagatran/ximelagatran compared with enoxaparin.

“…Traditional non-steroid anti-inflammatory drugs (NSAIDs) are widely used as analgesics but their use is discontinued before major surgery in order to avoid increased perioperative blood loss (Fauno et al 1993, Slappendel et al 2002, Weber et al 2003. Traditional NSAIDs inhibit the cyclooxygenase isoenzymes COX-1 and COX-2.…”

mentioning

confidence: 99%

Effects of celecoxib on blood loss, pain, and recovery of function after total knee replacement: A randomized placebo-controlled trial

2007

Background Pain management after surgery has been used as a sales argument for the use of COX-2 inhibitors, but their potential positive and negative effects have not been fully investigated. We thus conducted a controlled evaluation of the effect of celecoxib on perioperative blood loss, pain relief and consumption of analgesics, range of motion, and subjective outcome in conjunction with total knee replacement (TKR).Method 50 patients were randomized to either placebo or celecoxib (200 mg) preoperatively and then twice daily. Total blood loss was calculated by the Hb balance method, taking the patient's pre-and postoperative hemoglobin and blood volume into account. Pain scores (VAS), range of motion, and subjective outcome (KOOS) were monitored postoperatively and during the first year after surgery.Results No differences in total, hidden, or drainage blood loss were found between the groups. There were 30% lower pain scores during the first 4 weeks after surgery and lower morphine consumption after surgery in the celecoxib group, while no effect was seen on pain, range of motion, and subjective outcome at the 1 year follow-up.Interpretation Celecoxib does not increase perioperative blood loss but reduces pain during the postoperative period after TKR. It is not necessary to discontinue celecoxib before surgery. The postoperative use of celecoxib did not increase range of motion or subjective outcome 1 year after TKR.