[Perioperative anti-inflammatory drug use: which evidences for their utility and safety?]

To bring together the most recent evidences concerning the utility and safety of perioperative anti-inflammatory drug use.

References were obtained from computerised bibliographic data banks (MeSH terms: NSAIDs, coxibs, steroids, surgery, anaesthesia), followed by manual search.

NSAIDs, coxibs and steroids used alone or in association have been demonstrated to be effective for relieving postoperative pain. However, the benefits of perioperative anti-inflammatory drug use may go beyond the postoperative analgesia. In some cases, anti-inflammatory drugs have been shown to decrease the incidence of morphine side-effects, postoperative nausea and vomiting or to improve postoperative recovery. Nevertheless, NSAIDs have been found to be a risk factor of severe postoperative bleeding requiring surgical haemostasis after some surgical procedures. In contrast, coxibs have been shown to promote arterial thrombosis after others surgical procedures.