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[NSAID demonstrate convincing effect on postoperative pain].

Martin Engström1, Ole Naesh

  • 1Dept of Anesthesiology and Intensive Care, Universitetssjukhuset i Lund, SE-221 85 Lund, Sweden. Martin.Engstrom@skane.se

Lakartidningen
|June 27, 2002
PubMed
Summary

Non-steroidal anti-inflammatory drugs (NSAID) offer benefits for postoperative pain management within multimodal approaches. However, clinicians must weigh these advantages against potential risks like bleeding and impacts on coagulation and renal function, especially in the perioperative setting.

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Area of Science:

  • Anesthesiology and Pain Management
  • Pharmacology

Background:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly integrated into multimodal strategies for managing postoperative pain.
  • A significant clinical debate exists regarding the perioperative administration of NSAIDs due to concerns about potential adverse effects.
  • These concerns include impacts on coagulation, renal function, and the risk of gastrointestinal bleeding.

Purpose of the Study:

  • To critically evaluate the advantages and disadvantages of using NSAIDs during the perioperative period.
  • To provide a balanced perspective on NSAID use in the context of postoperative pain management.
  • To discuss alternatives to NSAIDs and the role of newer COX2-selective inhibitors.

Main Methods:

  • This is a review article, synthesizing existing literature and clinical considerations.

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  • The review examines the evidence for and against perioperative NSAID use.
  • It addresses the rationale behind multimodal pain management and discusses alternative pharmacologic options.

    • Main Results:

    • While long-term NSAID use is associated with adverse effects, their applicability to the perioperative period requires careful consideration.
    • Potential benefits include effective pain relief as part of a multimodal regimen.
    • Clinicians must be aware of the specific risks, such as bleeding and renal effects, even in short-term perioperative use.

    Conclusions:

    • Perioperative NSAID use presents a balance between effective pain management and potential risks.
    • A thorough understanding of NSAID pharmacology and patient-specific factors is crucial for safe and effective application.
    • The review highlights the need for informed clinical decision-making regarding NSAIDs and their alternatives in postoperative care.