Document Detail


Pain treatment with a COX-2 inhibitor after coronary artery bypass operation: a randomized trial.
MedLine Citation:
PMID:  12607659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Franz F Immer; Alexsandra S Immer-Bansi; Nathalie Trachsel; Pascal A Berdat; Verena Eigenmann; Michele Curatolo; Thierry P Carrel
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  75     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-27     Completed Date:  2003-03-17     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  490-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Division of Pain Therapy, University Hospital, Berne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analgesics, Opioid / therapeutic use
Coronary Artery Bypass*
Creatinine / blood
Cyclooxygenase 2
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors / therapeutic use*
Diclofenac / therapeutic use
Etodolac / therapeutic use*
Female
Humans
Isoenzymes / antagonists & inhibitors*
Male
Membrane Proteins
Middle Aged
Pain, Postoperative / prevention & control*
Prostaglandin-Endoperoxide Synthases
Tramadol / therapeutic use
Urea / blood
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Cyclooxygenase 2 Inhibitors; 0/Cyclooxygenase Inhibitors; 0/Isoenzymes; 0/Membrane Proteins; 15307-86-5/Diclofenac; 27203-92-5/Tramadol; 41340-25-4/Etodolac; 57-13-6/Urea; 60-27-5/Creatinine; EC 1.14.99.1/Cyclooxygenase 2; EC 1.14.99.1/PTGS2 protein, human; EC 1.14.99.1/Prostaglandin-Endoperoxide Synthases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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