Why the study?
Does meloxicam reduce perioperative blood loss compared to indomethacin in patients undergoing total hip replacement?
Does meloxicam reduce perioperative blood loss compared to indomethacin in patients undergoing total hip replacement?
The use of the COX-2 selective NSAID meloxicam significantly reduces perioperative blood loss compared to the non-selective NSAID indomethacin in patients undergoing total hip replacement.
Meloxicam may be preferred over indomethacin to limit blood loss after total hip replacement; supports COX-2 selective NSAIDs for perioperative use.
BACKGROUND: In this prospective randomized study we tested the hypothesis that use of more cyclo-oxygenase 2 (COX 2)-selective non-steroidal anti-inflammatory drugs (NSAIDs) can reduce perioperative blood loss compared with non-selective NSAIDs. METHODS: Data from 200 patients who underwent total hip replacement were studied. Two NSAIDs were compared: indomethacin 50 mg (n = 82) and meloxicam 15 mg (n = 86). Both NSAIDs were given orally 1 h before surgery. RESULTS: The two groups were not different with respect to age, gender, ASA class or duration of surgery. When indomethacin was used preoperatively, intraoperative blood loss was 623 +/- 243 mL (mean +/- SD) and postoperative blood loss 410 +/- 340 mL. After meloxicam, these values were 524 +/- 304 mL and 358 +/- 272 mL, respectively. Total perioperative blood loss after meloxicam was 17% (P < 0.05) less than that observed after indomethacin. CONCLUSION: Perioperative blood loss after meloxicam is less than after indomethacin. These in vivo findings are consistent with in vitro results using selective COX 2 NSAIDs.
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Weber et al. (2005) studied this question.
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