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NSAIDs safe, effective after prostatectomy, new data reveal
Friday, December 26 2008 | Comments
What's This?
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a safe alternative for postoperative analgesia after radical retrospective prostatectomy (RRP) and do not increase the risk of postoperative hemorrhage, according to recently published study results.Many urologists are reluctant to use NSAIDs after RRP because of hemorrhagic complications, even though there have been no prospective, randomized studies examining the effects of NSAIDs on postoperative bleeding after RRP, the authors explained.
To remedy this lack of evidence, the authors conducted a prospective study in 100 men undergoing open RRP. The men were randomized to receive an NSAID (lornoxicam) or parcetamol for postoperative analgesia. Primary endpoints included hemoglobin (Hb) differences, estimated blood loss, number of transfusions, and drain output.
Results showed that differences in postoperative Hb levels the day of the surgery and postoperative day 1 and day 2 were not statistically significant between the 2 groups. In addition, Hb decreases were not statistically significant between the 2 groups.
Five patients (10%) of patients in the non-NSAID group were transfused postoperatively with 7 blood units in total compared with 7 patients (14%) with the same number of blood units in the NSAID group (P<=1).
The entire cohort was discharged without drains.
In addition, the two groups had similar pain scores on postoperative days 1, 4, and 5, while on days 2 and 3, the results were statistically significant in favor of lornoxicam (P<=.01 and P<=.025, respectively).
The size of the study was small and further studies are needed to confirm the findings, the authors concluded. (Mazaris E, et al. Urology 2008;72:1293-1297.)
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