Premedication with meloxicam exacerbates intracranial hemorrhage in an immature swine model of non-impact inertial head injury

摘要

Meloxicam is a cyclo-oxgenase-2 preferential non-steroid anti-inflammatory drug with very effective analgesic and anti-inflammatory effects in swine. Previous reports in piglets have demonstrated that meloxicam also inhibits cyclo-oxgenase-1 and reduces production of thromboxane significantly. We use pre-injury analgesia in our immature swine (3–5 day old piglets) model of brain injury using rapid head rotations without impact. In 23 consecutive subjects we found that premedication with meloxicam (N=6) produced a significantly higher mortality rate (5/6 or 83%) than buprenorphine (N =17, 1/17 or 6%, p < 0.02). On gross neuropathologic examination of the meloxicam-treated swine, we observed massive subdural and subarachnoid bleeding which were not present in buprenorphine-premedicated animals. To our knowledge there are no previous reports in swine of increased bleeding or platelet inhibition associated with meloxicam administration and further research is needed to define mechanisms of action in piglets. We caution the use of meloxicam in swine when inhibition of platelet aggregation might adversely affect refinement of experimental research protocols, such as in stroke, trauma, and cardiac arrest models.