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Abstract
The known effects of commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) on
hemostatic parameters have led to concern over their use in the perioperative period.
Nabumetone, unlike other NSAIDs, has little effect on collagen-induced platelet aggregation.
To evaluate the effect of nabumetone 2000 mg daily on other hemostatic parameters
(eg, bleeding time, prothrombin time, and partial thromboplastin time) in the clinical
setting, this double-masked study was conducted in patients with osteoarthritis undergoing
arthroscopic knee surgery. After a 1-week placebo washout period, 58 patients were
randomized to receive nabumetone and 53 were randomized to receive placebo. They were
assessed before surgery (after 1 to 2 weeks of treatment) and again after surgery
(after an additional 3 weeks of treatment). The study was designed to have 90% power
to show equivalence in bleeding time to within 1.5 minutes, a difference assumed to
be of no clinical importance. No meaningful differences were observed between the
groups in any of the measured hemostatic parameters. Before surgery, the bleeding
time increased by only 0.3 minutes with nabumetone and decreased by 0.2 minutes with
placebo. The mean (± SD) difference between the groups in change from baseline was
0.5 ± 0.3 minutes. After surgery, the changes were 0.1 minutes and 0.0 minutes, respectively,
and the difference between groups was 0.2 ± 0.3 minutes. These differences were neither
statistically nor clinically significant, and maximum individual increases were similar
in each group. Furthermore, there were no reports of abnormal bleeding in the operative
knees. The results of this study show that nabumetone had little or no effect on hemostasis
and suggest that this drug can be used safely in the perioperative period.
Keywords
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© 1998 Published by Elsevier Inc.
