| Pain treatment with a COX-2 inhibitor after coronary artery bypass operation: a randomized trial. | |
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MedLine Citation:
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PMID: 12607659 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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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Authors:
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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:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 75 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-02-27 Completed Date: 2003-03-17 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 490-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Surgery, Division of Pain Therapy, University Hospital, Berne, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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