Abstract
We have frequently used NSAIDs including loxoprofen sodium hydrate （loxoprofen） for postoperative pain management in the head and neck region, but loxoprofen inhibits platelet aggregation by inhibiting COX and may cause postoperative bleeding. On the other hand, acetaminophen has little COX inhibitory effect and has a low risk of postoperative bleeding. I examined the relationship between each analgesic and postoperative bleeding in patients in whom a polyglycolic acid sheet was applied to the raw surface after partial glossectomy.
From April 2011 to September 2019, we investigated 47 patients who underwent partial glossectomy followed by covering with a polyglycolic acid sheet and fibrin glue. The patients were divided into two groups, those using acetaminophen or those using loxoprofen, for postoperative pain management, and the analgesic effects were compared between the groups. Next, the relationship between postoperative bleeding and clinical factors including analgesic type was statistically examined.
Of the 47 patients, 11 （23.4％） had postoperative bleeding. There was no statistically significant difference in the frequency of use of analgesics between the groups, and it was considered that the analgesic effects of both groups were equivalent. Postoperative bleeding was significantly higher in the loxoprofen group （33.3％） than in the acetaminophen group （5.9％） （p＝0.033）, indicating the high risk of postoperative bleeding in the loxoprofen group.
Based on the results of this study and other reports, it may be necessary to consider refraining from using NSAIDs containing loxoprofen in patients undergoing this treatment, because NSAIDs are analgesics with a high risk of postoperative bleeding associated with COX inhibitory effects.
