PMID: 16508386Mar 2, 2006Paper

Postoperative modulation of central nervous system prostaglandin E2 by cyclooxygenase inhibitors after vascular surgery

Anesthesiology
S S ReubenRobert B Steinberg

Abstract

The clinical availability of injectable cyclooxygenase inhibitors allows examination of the importance of cyclooxygenase 1 and 2 after surgery. The authors hypothesize that spinal prostaglandin E2 increases with lower extremity vascular surgery and that spinal prostaglandin E2 decreases with intravenous postsurgical administration of either a mixed cyclooxygenase 1/2 inhibitor (ketorolac) or a cyclooxygenase 2 selective inhibitor (parecoxib). Thirty patients undergoing elective lower extremity revascularization under continuous spinal anesthesia had cerebrospinal fluid obtained at baseline and then up to 6 h after the start of surgery. Four hours after surgical incision, patients were randomized to receive intravenous parecoxib 40 mg, ketorolac 30 mg, or preservative-free normal saline. Patients were administered intravenous fentanyl in the postanesthesia care unit and acetaminophen/oxycodone on the surgical ward to control pain. Cerebrospinal fluid prostaglandin E2 concentrations were increased during and after surgery. After surgery, intravenous parecoxib 40 mg rapidly decreased cerebrospinal fluid prostaglandin E2, and intravenous ketorolac 30 mg also reduced cerebrospinal fluid prostaglandin E2 compared with placebo, but no...Continue Reading

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Citations

Sep 5, 2006·British Journal of Sports Medicine·A Buvanendran, S S Reuben
Jul 25, 2006·Anesthesia and Analgesia·Jeffrey S KroinKenneth J Tuman
Aug 25, 2007·Anesthesia and Analgesia·Supranee NiruthisardKusonsi Toleb
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Apr 11, 2015·Pain Practice : the Official Journal of World Institute of Pain·Hong Chen, Ailin Luo
Aug 13, 2013·Experimental and Therapeutic Medicine·Ya-Jing GuoRu-Ping Dai
Feb 17, 2009·Anesthesiology

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