The Use of NSAIDs in the Postoperative Period: Advantage and Disadvantages

Abstract

NSAIDs are commonly used as single analgesics in minor surgery or as component of multimodal analgesia associated with opioids or locoregional techniques in the postoperative period to assure a better analgesia and reduce the dose of opioids. The analgesic potency evaluated as number needed to treat (NNT) is not very different between the traditional non selective NSAIDs and the selective cyclo-oxygenase-2-inhibitors (Coxibs). The effectiveness as analgesics is unquestionable also if these drugs are not devoid of risks. There is debate in literature about the possible side effects when administered in the perioperative period: anastomotic leakage, reduced ossification, bleeding and acute renal failure. Recent data underline as the Coxibs but also traditional NSAIDs can induce cardiac toxicity even if they are utilized for few days. The aim of this review is to provide an overview of the effectiveness and side effects of selective and non-selective NSAIDs in the perioperative period.