Post-Operative Bleed Risks Associated with Perioperative Nonsteroidal Anti-Inflammatory Drugs: A Narrative Review.

Area of Science:

• Pharmacology
• Surgical Medicine
• Evidence-Based Practice

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain and inflammation.
• Concerns exist regarding NSAID-associated bleeding risks, particularly around surgical procedures.
• The safety of NSAID use during the perioperative period remains a subject of debate.

Purpose of the Study:

• To review recent literature (past 10 years) on post-operative bleeding risks associated with perioperative NSAID use.
• To synthesize evidence regarding the impact of NSAIDs on bleeding complications after surgery.

Main Methods:

• Systematic literature search for randomized controlled trials, meta-analyses, and reviews.
• Inclusion of studies examining post-operative bleeding events in adult patients.
• Screening and review of 11 selected articles.

Main Results:

• The reviewed literature indicates that perioperative NSAIDs generally have a minimal effect on post-operative bleeding.
• Studies examined post-operative bleeding incidence, blood loss, hemoglobin decline, and hematoma/hemorrhage frequency.
• COX-2 selective NSAIDs may present a lower bleeding risk compared to nonselective NSAIDs.

Conclusions:

• Perioperative NSAID use appears to have a low impact on post-operative bleeding risk.
• COX-2 selective agents may be preferable to nonselective NSAIDs in surgical contexts.
• Individualized patient and procedural factors should guide NSAID decisions in the perioperative period.