Key result
Diclofenac fails to reduce postoperative pericardial effusion grade compared to placebo.
Why the study?
The efficacy of nonsteroidal anti-inflammatory drugs in reducing postoperative pericardial effusion volume after cardiac surgery had not been assessed.
Does diclofenac reduce pericardial effusion volume in patients with persistent moderate to large pericardial effusion after cardiac surgery?
Population
196 patients at high risk for tamponade with moderate to large persistent pericardial effusion after cardiac surgery
Comparison
Diclofenac 50 mg twice daily for 14 days vs matching placebo
Design
Multicenter randomized double-blind placebo-controlled study
Follow-up
14 days
Authors
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No role for diclofenac in postoperative pericardial effusion; challenges prior observational data and supports avoiding its routine use.
RCT (n=196)
double-blind
Random assignment at each site in blocks of 4
Yes
Does diclofenac reduce pericardial effusion volume in patients with persistent moderate to large pericardial effusion after cardiac surgery?
Mean Difference: -0.28 (95% CI -0.63–0.06)
Absolute Event Rate: -1.36% vs -1.08%
p-value: p=0.105
In patients with postoperative pericardial effusion, diclofenac did not significantly reduce effusion size or prevent late cardiac tamponade compared to placebo.
Philippe Meurin (2010) conducted an RCT in postoperative pericardial effusion (n=196). diclofenac vs. placebo was evaluated on change in effusion grade after 14 days of treatment (MD -0.28, 95% CI -0.63 to 0.06, p=0.105). Diclofenac did not significantly reduce postoperative pericardial effusion grade compared to placebo (mean difference -0.28 grade; 95% CI, -0.63 to 0.06; P=0.105).
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