Neil A Goldenberg1, Linda Jacobson, Marilyn J Manco-Johnson. 1. Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Health Sciences Center, Aurora, Colorado 80045-0507, USA. neil.goldenberg@uchsc.edu
Abstract
BACKGROUND: Despite a paucity of evidence, clinicians routinely advise that patients discontinue using nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, at least 1 week before most surgical procedures. OBJECTIVE: To define the duration of ibuprofen-induced platelet dysfunction. DESIGN: Prospective cohort study. SETTING: Denver/Aurora, Colorado. PARTICIPANTS: 11 healthy adult volunteers. MEASUREMENTS: Individuals were tested at baseline and serially after completion of a 7-day course of ibuprofen (600 mg orally every 8 hours). The platelet function analyzer (PFA-100, Dade Behring, Newark, Delaware), a test that has replaced the bleeding time in many clinical settings, was used. RESULTS: All participants exhibited normal platelet function before starting ibuprofen. Platelet dysfunction was apparent after completion of the ibuprofen course in 7 of the 11 participants and normalized by 24 hours after the last ibuprofen dose. LIMITATIONS: The sample size in this study was small, and no participants had a major illness. Correlation between PFA-100 results and clinical bleeding has not been established. CONCLUSIONS: Platelet function seems to normalize within 24 hours after cessation of regular ibuprofen use in healthy individuals. Further studies are warranted to provide a rational basis for timing of NSAID withdrawal in a range of patients undergoing surgery.
BACKGROUND: Despite a paucity of evidence, clinicians routinely advise that patients discontinue using nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, at least 1 week before most surgical procedures. OBJECTIVE: To define the duration of ibuprofen-induced platelet dysfunction. DESIGN: Prospective cohort study. SETTING: Denver/Aurora, Colorado. PARTICIPANTS: 11 healthy adult volunteers. MEASUREMENTS: Individuals were tested at baseline and serially after completion of a 7-day course of ibuprofen (600 mg orally every 8 hours). The platelet function analyzer (PFA-100, Dade Behring, Newark, Delaware), a test that has replaced the bleeding time in many clinical settings, was used. RESULTS: All participants exhibited normal platelet function before starting ibuprofen. Platelet dysfunction was apparent after completion of the ibuprofen course in 7 of the 11 participants and normalized by 24 hours after the last ibuprofen dose. LIMITATIONS: The sample size in this study was small, and no participants had a major illness. Correlation between PFA-100 results and clinical bleeding has not been established. CONCLUSIONS: Platelet function seems to normalize within 24 hours after cessation of regular ibuprofen use in healthy individuals. Further studies are warranted to provide a rational basis for timing of NSAID withdrawal in a range of patients undergoing surgery.
Authors: Andrew M Naidech; Storm M Liebling; Neil F Rosenberg; Paul F Lindholm; Richard A Bernstein; H Hunt Batjer; Mark J Alberts; Hau C Kwaan Journal: Neurocrit Care Date: 2012-02 Impact factor: 3.210
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