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Study Questions Ibuprofen Ban Before Surgery

The drug's effects on clotting may be too brief to matter

TUESDAY, April 5, 2005 (HealthDay News) -- The doctor's standard advice to avoid taking ibuprofen several days before surgery might be overly cautious, a small study suggests.

That advice is intended to prevent excess bleeding because ibuprofen -- and other painkillers classified as nonsteroidal anti-inflammatory drugs (NSAIDs) -- interfere with the activity of blood cells called platelets, which are essential for clotting.

But a study of a small number of healthy volunteers found platelet activity returned to normal within 24 hours, and a lot sooner for some participants, after taking the over-the-counter drug.

Because the study included only 11 people, it's still too soon to say the no-ibuprofen rule should be changed, according to lead researcher Dr. Neil A. Goldenberg, a clinical research fellow at the University of Colorado Health Sciences Center.

"But it is something that should prompt larger studies in more diverse populations," Goldenberg added. Such studies should include other NSAIDS, such as naproxen (Aleve), he said.

Goldenberg said his team is in the early stages of planning such a study. "We definitely are interested in determining an appropriate population in which to look at this more closely," he said.

According to Goldenberg, current recommendations about when NSAIDs should be stopped "are all over the map."

One survey of gastroenterologists found two-thirds of the doctors had patients avoiding the drugs four to seven days before a procedure. Another guideline says patients should tell physicians about any NSAID use two weeks before surgery, while another said NSAIDs should be withdrawn just one to three days before surgery.

One intriguing finding of the study was that platelet function remained normal at all times in four participants, three of them women taking estrogen-containing oral contraceptives. "That raises the question of whether platelet function may be modified by other drugs," Goldenberg said.

Whatever the ultimate finding, the study "reinforces the appreciation that use of these drugs is something that should be paid attention to when planning surgery," the Colorado expert said. "It does suggest that it is very important to determine whether patients are taking these drugs and make an evaluation of how long a surgeon is comfortable with them taking these drugs before surgery."

More information

The full ibuprofen story is told by the National Library of Medicine

SOURCES: Neil A. Goldenberg, M.D., clinical research fellow, University of Colorado Health Sciences Center, Aurora; April 5, 2005, Archives of Internal Medicine
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