Pain treatment with a COX-2 inhibitor after coronary artery bypass operation: a randomized trial.
Ann Thorac Surg
; 75(2): 490-5, 2003 Feb.
Article
en En
| MEDLINE
| ID: mdl-12607659
ABSTRACT
BACKGROUND:
Adequate analgesic medication is mandatory after cardiac operations. Cyclooxygenase-2 inhibitors represent a new therapeutic option, acting primarily on the response to inflammation.METHODS:
We compared a cyclooxygenase-2 inhibitor (etodolac) with two traditional drugs a nonselective cyclooxygenase inhibitor (diclofenac) and a weak opioid (tramadol) on postoperative pain and renal function in patients undergoing coronary artery bypass operations. Sixty consecutive patients were randomized into three groups (1) group A patients who received tramadol; (2) group B patients who received diclofenac; and (3) group C patients who received etodolac. For measurement of analgesic effect, the visual analogue scale was assessed up to postoperative day 4. Creatinine-clearance was determined before and at the end of study medication, and serum creatinine and urea were monitored daily for renal effects. Study medication was given on postoperative days 2 and 3. Side effects and additional pain medication were recorded.RESULTS:
The visual analogue scale was lower in group C (p < 0.05) from postoperative days 2 to 4 and in group B (p < 0.05) from postoperative days 3 to 4 compared with group A. Amount of additional pain medication and incidence of side effects were significantly less in group C compared with group A. We observed a short-lasting elevation of serum creatinine and urea in groups B and C compared with group A (p < 0.05).CONCLUSIONS:
At the doses analyzed, etodolac and diclofenac produced better postoperative pain relief with less side-effects than tramadol. A short-lasting impairment of renal function was found in patients treated with etodolac and diclofenac.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Puente de Arteria Coronaria
/
Inhibidores de la Ciclooxigenasa
/
Etodolaco
/
Isoenzimas
Tipo de estudio:
Clinical_trials
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Thorac Surg
Año:
2003
Tipo del documento:
Article
País de afiliación:
Suiza