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Effect of non-steroidal anti-inflammatory drugs on post-surgical complications against the backdrop of the opioid crisis.
Zhao-Fleming, Hannah; Hand, Audrey; Zhang, Kelly; Polak, Robert; Northcut, Armand; Jacob, Daron; Dissanaike, Sharmila; Rumbaugh, Kendra P.
Afiliación
  • Zhao-Fleming H; 1Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8312, Lubbock, TX 79430 USA.
  • Hand A; 2Burn Center of Excellence, Texas Tech University Health Sciences Center, Lubbock, TX USA.
  • Zhang K; 1Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8312, Lubbock, TX 79430 USA.
  • Polak R; 1Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8312, Lubbock, TX 79430 USA.
  • Northcut A; 1Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8312, Lubbock, TX 79430 USA.
  • Jacob D; 1Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8312, Lubbock, TX 79430 USA.
  • Dissanaike S; 3School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX USA.
  • Rumbaugh KP; 1Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8312, Lubbock, TX 79430 USA.
Burns Trauma ; 6: 25, 2018.
Article en En | MEDLINE | ID: mdl-30221175
ABSTRACT
The USA is currently going through an opioid crisis, associated with tremendous economic and societal impacts. In response to this crisis, healthcare professionals are looking for alternative pain management methods, and non-steroidal anti-inflammatory drugs (NSAIDs) are a sensible choice because of their effectiveness after surgical procedures. However, before surgeons start prescribing NSAIDs in place of opioids, it is crucial to first understand their potential post-surgical complications. The goal of this review is to summarize the data obtained through both animal and human studies, which suggest how a dramatic increase in NSAID use may affect these post-surgical complications. We first provide a short review outlining the mechanisms of action of NSAIDs, followed by a summary of animal studies, which show a trend towards the negative effects of NSAIDs on wound healing and an association between NSAID use and wound infections. Lastly, we present evidence from human studies on the association of NSAIDs with the following complications anastomotic leaks, necrotizing soft tissue infections, bleeding complications, orthopedic injuries, wound healing, and cancer care. The human studies are much more variable in their conclusions as to whether NSAIDs are beneficial or not, with the only strong evidence showing that NSAIDs inhibit bone healing. This may partially be explained by male and female differences in response to NSAIDs as many animal studies showing the inhibitory effects of NSAIDs were performed on females, while all the human studies were performed with both sexes. We conclude that strong caution should be used in the prescription of NSAIDs, especially in female patients, but larger scale studies are warranted before solid recommendations can be made.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 Problema de salud: 1_recursos_humanos_saude Idioma: En Revista: Burns Trauma Año: 2018 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 Problema de salud: 1_recursos_humanos_saude Idioma: En Revista: Burns Trauma Año: 2018 Tipo del documento: Article
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