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NSAIDs for Pain Control During the Peri-Operative Period of Hip Fracture Surgery: A Systematic Review
Wilhelm Pommier1, Elise-Marie Minoc2, Pierre-Marie Morice3
1Department of Geriatric Medicine, Centre Hospitalier Universitaire de Caen Normandie, 14000, Caen, France.
Drugs & Aging
|October 25, 2023
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) may help control pain after hip fracture surgery. However, evidence on their safety and impact on recovery is conflicting and uncertain, requiring further research.
Area of Science:
- Gerontology
- Orthopedic Surgery
- Pharmacology
Background:
- Hip fracture (HF) significantly impacts older adults, increasing morbidity and mortality.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for peri-operative pain management.
- Concerns exist regarding NSAID-associated adverse events in elderly populations undergoing HF surgery.
Approach:
- A systematic review adhering to PRISMA guidelines was performed.
- Searched PubMed, EMBASE, and Cochrane Central for relevant clinical trials and observational studies.
- Evaluated NSAID efficacy, safety, and impact on non-specific post-operative outcomes like functional status and complications.
Key Points:
- NSAIDs showed potential for pain control in hip fracture surgery, though opioid-sparing effects were inconsistent.
- No increased risk of acute kidney injury was observed, but bleeding and delirium risks yielded conflicting results.
- No studies demonstrated a positive effect of NSAIDs on walking recovery post-surgery.
Conclusions:
- NSAID use may be beneficial for pain management in peri-operative hip fracture care.
- Conflicting safety data and low certainty of evidence necessitate caution.
- Further research is required to establish the benefit-risk profile of NSAIDs in this patient group.
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