Preemptive Non-Steroidal Anti-Inflammatory Drugs for Orthopedic Surgery

Background: Pain and infection are two of the major unwanted outcomes of surgery that physician have long been trying to control. There has been a great deal of advancement to limit pain caused by surgery, from the anesthesia during surgery to the commonly used opioids after surgery. Preemptive analgesia is defined as an anti-nociceptive treatment that prevents establishment of altered processing of afferent input, which can increase postoperative pain. By reducing the level of prostaglandins in your body, NSAIDs help relieve pain any condition causing inflammation, fever, and also prevent clotting. For these reasons it is felt that the use of NSAIDS preemptively could be helpful in decreasing the sensation of pain before it starts. With the discomfort of surgery kept to a minimum, pain medications could be decreased. With the decrease of analgesic medication also comes the decrease of unwanted side effects the worst of these being, opioid addiction or dependancy. Methods: This systematic review examines original research that looks at the preemptive use of NSAIDS in orthopedic surgery and the effects on postoperative pain. There were many articles excluded for their use of vioxx, some that were older and all those that had Dr. Scott Reuben as an author due to fabricated data. Results: Three studies published in the last ten years comparing the use of NSAIDs to placebo and one observationally blinded study during orthopedic surgery where included. These four studies looked at the preemptive use of NSAIDs in orthopedic surgery and either compared it to placebo or no intervention. The articles found did look at postoperative pain and analgesic usage. Conclusion: NonSteroidal Anti-Inflammatory Drugs have been shown to have a greater postoperative effect on pain relief when given preemptively to those undergoing orthopedic surgery, than currently used postoperative practices. Opioid sparing is possible with preemptive use of NSAIDs, but were NSAIDs to be used every 12 hours after surgery further opioid sparing could be possible as discussed in the Haung et al study. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/225 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/225 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed. Preemptive Non-Steroidal Anti-Inflammatory Drugs for Orthopedic Surgery