Monday, December 15, 2008

NSAIDs Are Safe, Effective for Prostatectomy Pain

Study finds no increased risk of bleeding in patients given non-steroidal anti-inflammatory drugs

-- The use of non-steroidal anti-inflammatory drugs (NSAIDs) appears to be safe and effective for pain relief following radical retropubic prostatectomy, according to research published in the December issue of Urology.

Evangelos M. Mazaris, M.D., of the University of Athens in Greece, and colleagues analyzed data from 100 patients undergoing open radical retropubic prostatectomy who were randomized to receive paracetamol or the NSAID lornoxicam for two days following the surgery. Opiates were available for breakthrough pain if the patients desired. Most patients were discharged four or five days after the procedure.

Postoperative bleeding and transfusion rates were not statistically different between the paracetamol group and the NSAID group, the researchers report. Pain control, measured by visual analogue scale, was significantly better in the NSAID group on postoperative days 2 and 3, and was similar between the groups on days 1, 4 and 5, the investigators found.

Many urologists hesitate to give NSAIDs after this procedure due to possible hemorrhage, according to the authors. "It has been suggested that because NSAIDs cause transient impairment of platelet aggregation, reduced hemostasis in a postoperative setting may be of major concern," the authors write. However, "we were able to demonstrate in this pilot study that the use of NSAIDs after radical retropubic prostatectomy is a safe alternative that offers sufficient postoperative analgesia without an increased risk for postoperative hemorrhage."

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