Does use of intraoperative diclofenac sodium increase postoperative bleeding After prosthetic breast reconstruction?
Does use of intraoperative diclofenac sodium increase postoperative bleeding After prosthetic breast reconstruction ?
Mohammed Ben Aziz et al.,
Diclofenac | Anesthesia
Vol: 4; Iss: 11; Nov 18 | ISSN: 2454-5422
Background: Prosthetic breast reconstruction is the most commonly performed procedure in women following mastectomy. This painful procedure can be associated with some short- and long-term complications with prolonged hospital stay.
We evaluated the influence of diclofenac on intraoperative and postoperative complications as well as length of hospital stay.
Methods: A retrospective study comparing two groups of patients for intraoperative and postoperative complications undergoing Prosthetic breast reconstruction after prophylactic or curative mastectomy according to the type of intraoperative analgesia received.
Group diclofenac included 59 patients undergoing the procedure under general anesthesia with intraoperative diclofenac and group no diclofenac had 75 patients undergoing the same procedure under general anesthesia without intraoperative diclofenac.
Results: The two groups were comparable in terms of demographic Characteristics, preoperative radiotherapy and chemotherapy and the primary location of the tumor.
Intraoperative variables were not statistically different between the two groups except for intraoperative piritramide (P = 0.03).
Postoperative piritramide consumption was more frequently observed in group no diclofenac compared to group diclofenac (P =0.02) while there were no statistically significant difference for local complications and postoperative blood loss.
Length of hospital stay was higher in the group diclofenac (p=0.005)
Conclusion: Intraoperative administration of diclofenac seems to be safe on postoperative bleeding after Prosthetic breast reconstruction.
These findings should be confirmed in large prospective studies using specific guidelines. The relatively low number of serious complications denotes an adequate preoperative screening and stresses the importance of adequate maintenance of parameters throughout the perioperative process.
Clinical relevance: This study suggests that using intraoperative diclofenac may be safe on postoperative bleeding and blood transfusion and may reduce postoperative pain.