Zusammenfassung
Objective: Non-selective NSAIDs can cause serious gastrointestinal side-effects. Selective COX-2 blockers are a reasonable alternative for pain treatment. They do not seem to affect platelet function and consequently cause a lower perioperative blood loss than non-selective NSAIDs. This study compared etoricoxib and diclofenac during a perioperative (9 days) period after THA to investigate total ...
Zusammenfassung
Objective: Non-selective NSAIDs can cause serious gastrointestinal side-effects. Selective COX-2 blockers are a reasonable alternative for pain treatment. They do not seem to affect platelet function and consequently cause a lower perioperative blood loss than non-selective NSAIDs. This study compared etoricoxib and diclofenac during a perioperative (9 days) period after THA to investigate total blood loss and gastrointestinal tolerability. The hypothesis was that etoricoxib is superior to diclofenac. Methods: A total of 100 patients (50 in each group) were included in this trial. Etoricoxib (90mg) was administered once and diclofenac sodium (75mg) twice daily for 9 days. Total blood loss during and after primary cementless THA was detected. The rate of adverse events (AEs) and serious adverse events (SAEs) was analyzed to detect gastrointestinal tolerability. Results: The mean total blood loss (calculated) was 1548 +/- SD 468ml in the etoricoxib (ETO) group and 1649 (SD 547) ml in the diclofenac (DIC) group. The mean duration of THA was 81min (SD 29) in the DIC and 75min (SD 30) in the ETO group. Hence, the mean calculated total blood loss was 101ml higher in the DIC group. This difference was not statistically significant (p=0.334). Fifty-six patients (28 in each group) received a cell saver retransfusion, but only one patient (ETO group) needed an additional red blood cell transfusion. The hidden blood loss was 1067ml (SD 603) in the DIC group and 999ml (SD 378) in the ETO group. The gastrointestinal tolerability (number of adverse and serious adverse events) was not significantly different between groups. Conclusion: There was no statistically significant difference in perioperative blood loss after primary THA under etoricoxib (90mg) compared to diclofenac (75mg). Furthermore, no gastrointestinal superiority of etoricoxib could be detected during a short period of 9 days.
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