Moote C
Department of Anaesthesia, University Hospital, London, Ontario, Canada.
Drugs. 1992;44 Suppl 5:14-29; discussion 29-30. doi: 10.2165/00003495-199200445-00004.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are very effective for the management of acute postoperative pain. These agents can be used in combination with opioid analgesics and local anaesthetics for the relief of severe postoperative pain, when the combination results in reduced narcotic requirements and improved analgesia compared with opioids and/or local anaesthetics. NSAIDs have been shown to be effective in a wide variety of postoperative pain states, including thoracotomy, major orthopaedic surgery such as hip arthroplasty, upper and lower abdominal surgery and minor outpatient surgery. The benefits of combining NSAIDs with opioid analgesics in the immediate postoperative period include not only improved analgesia but also the benefits associated with narcotic sparing (improved respiratory function, reduction in nausea and vomiting, reduced sedation) and there is a suggestion that NSAIDs may improve not only the quality but also the speed of recovery. By adding the NSAIDs to a routine analgesic armamentarium the goal of preventing or eliminating postoperative pain, rather than treating or reducing postoperative pain, is achieved. To use these agents more effectively, further research is required to distinguish the differences between the various NSAIDs, the optimal dosage schedules and route of administration, and, finally, the cost-effectiveness and impact on the quality and speed of postoperative recovery of NSAIDs.
非甾体抗炎药（NSAIDs）对急性术后疼痛的管理非常有效。这些药物可与阿片类镇痛药和局部麻醉药联合使用，以缓解严重的术后疼痛，此时与单独使用阿片类药物和/或局部麻醉药相比，联合使用可减少麻醉剂用量并改善镇痛效果。NSAIDs已被证明在多种术后疼痛状态下有效，包括开胸手术、诸如髋关节置换术等大型骨科手术、上下腹部手术以及小型门诊手术。在术后即刻将NSAIDs与阿片类镇痛药联合使用的益处不仅包括镇痛效果改善，还包括与减少麻醉剂使用相关的益处（改善呼吸功能、减少恶心和呕吐、减轻镇静作用），并且有迹象表明NSAIDs不仅可能改善恢复质量，还可能加快恢复速度。通过将NSAIDs添加到常规镇痛药物库中，可以实现预防或消除术后疼痛的目标，而不仅仅是治疗或减轻术后疼痛。为了更有效地使用这些药物，需要进一步研究以区分各种NSAIDs之间的差异、最佳给药方案和给药途径，以及最终NSAIDs的成本效益及其对术后恢复质量和速度的影响。
