OBJECTIVES: To assess the efficacy and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) administered after radical retropubic prostatectomy (RRP). METHODS:One hundred patients undergoing open RRP by one surgeon were divided randomly and prospectively into two groups of 50 patients, each receiving systematically either an NSAID (lornoxicam) or paracetamol for postoperative analgesia. Opiates were administered if needed for breakthrough pain. Parameters potentially correlated with postoperative bleeding, such as preoperative and postoperative hemoglobin (Hb) differences, estimated blood loss, number of transfusions, and drain output were recorded. Furthermore, the degree of pain was assessed daily with a visual analogue scale score until discharge from hospital. RESULTS: After procedures with similar estimated blood loss, postoperative bleeding was not more in the NSAIDs group, as evidenced by similar transfusion rates (P <or=1), similar postoperative Hb values (P >0.05), and Hb drop after the procedure. No patient required re-exploration for bleeding; drain output when elevated was never attributed to postoperative bleeding. Pain control as evaluated by the visual analogue scale pain score was adequate with the use of NSAIDs and not statistically different from the non-NSAIDs group during postoperative days 1 and 4 and onward. Pain control with lornoxicam was even better on postoperative days 2 and 3 (P <or=0.05). CONCLUSIONS:Nonsteroidal anti-inflammatory drugs administered after open RRP are safe and effective. They do not increase the risk of bleeding and offer improved analgesia.
RCT Entities:
OBJECTIVES: To assess the efficacy and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) administered after radical retropubic prostatectomy (RRP). METHODS: One hundred patients undergoing open RRP by one surgeon were divided randomly and prospectively into two groups of 50 patients, each receiving systematically either an NSAID (lornoxicam) or paracetamol for postoperative analgesia. Opiates were administered if needed for breakthrough pain. Parameters potentially correlated with postoperative bleeding, such as preoperative and postoperative hemoglobin (Hb) differences, estimated blood loss, number of transfusions, and drain output were recorded. Furthermore, the degree of pain was assessed daily with a visual analogue scale score until discharge from hospital. RESULTS: After procedures with similar estimated blood loss, postoperative bleeding was not more in the NSAIDs group, as evidenced by similar transfusion rates (P <or=1), similar postoperative Hb values (P >0.05), and Hb drop after the procedure. No patient required re-exploration for bleeding; drain output when elevated was never attributed to postoperative bleeding. Pain control as evaluated by the visual analogue scale pain score was adequate with the use of NSAIDs and not statistically different from the non-NSAIDs group during postoperative days 1 and 4 and onward. Pain control with lornoxicam was even better on postoperative days 2 and 3 (P <or=0.05). CONCLUSIONS: Nonsteroidal anti-inflammatory drugs administered after open RRP are safe and effective. They do not increase the risk of bleeding and offer improved analgesia.
Authors: Tasce Bongiovanni; Elizabeth Lancaster; Yeranuí Ledesma; Evans Whitaker; Michael A Steinman; Isabel Elaine Allen; Andrew Auerbach; Elizabeth Wick Journal: J Am Coll Surg Date: 2021-01-27 Impact factor: 6.532