BACKGROUND AND OBJECTIVE:To investigate whether preemptive administered lornoxicam changes perioperative platelet function during thoracic surgery. METHODS:A total of 20 patients scheduled for elective thoracic surgery were randomly assigned to receive either lornoxicam (16 mg, i.v.; n = 10) or placebo (n = 10) preoperatively. All patients underwent treatment of solitary lung metastasis and denied any antiplatelet medication within the past 2 weeks. Blood samples were drawn via an arterial catheter directly into silicone-coated Vacutainer tubes containing 0.5 mL of 0.129 M buffered sodium citrate 3.8% before, 15 min, 4 h and 8 h after the study medication was administered. Platelet aggregation curves were obtained by whole blood electrical impedance aggregometry (Chrono Log). RESULTS:Platelet aggregation was significantly reduced 15 min, 4 h and 8 h after lornoxicam administration compared to placebo (P < 0.05) for collagen, adenosine diphosphate and arachidonic acid as trigger substances. Adenosine diphosphate-induced platelet aggregation decreased by 85% 15 min after lornoxicam administration, and remained impaired for 8 h. CONCLUSION:Platelet aggregation assays are impaired for at least 8 h after lornoxicam application. Therefore perioperative analgesia by use of lornoxicam should be carefully administered under consideration of subsequent platelet dysfunction.

译文

背景与目的:探讨氯诺昔康在胸外科手术中是否能抢先使用围手术期血小板功能。
方法:总共20例计划进行择期胸外科手术的患者被随机分配为术前接受氯诺昔康(16 mg,i.v .; n = 10)或安慰剂(n = 10)。在过去的两周内,所有患者均接受了孤立性肺转移的治疗,并拒绝使用任何抗血小板药物。在施用研究药物之前,15分钟,4小时和8小时之后,通过动脉导管将血液样品直接抽取到装有0.5 mL 0.129 M柠檬酸钠3.8%的硅胶涂层的Vacutainer管中,该溶液的浓度为3.8%。通过全血电阻抗凝集法(Chrono Log)获得血小板聚集曲线。
结果:与安慰剂相比,氯诺昔康给药后15 min,4 h和8 h血小板聚集明显减少(P <0.05),其中胶原,腺苷二磷酸和花生四烯酸为触发物质。氯诺昔康给药后15分钟,二磷酸腺苷诱导的血小板凝集减少了85%,并持续受损8小时。
结论:氯诺昔康应用后至少8 h血小板聚集测定受损。因此,在考虑随后的血小板功能障碍时,应谨慎使用氯诺昔康围手术期镇痛。

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