Kehlet H, Dahl J B
Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.
Drugs. 1992;44 Suppl 5:38-41. doi: 10.2165/00003495-199200445-00006.
It is well documented that long term treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of peptic ulcer and that gastroduodenal mucosal erosions can be demonstrated in volunteers within 1 week of treatment initiation. However, long term studies in nonsurgical patients have not documented gastroduodenal complications within the first week of treatment. Cumulative data from controlled studies of perioperative (> or = 48 hours and < or = 7 days) treatment with NSAIDs do not suggest an increased risk of gastroduodenal complications (such as bleeding/perforation) within this time frame. We conclude that the otherwise well documented gastrointestinal side effects of prolonged treatment with NSAIDs should not hinder short term NSAID treatment for improved analgesia after surgery.
有充分文献记载,长期使用非甾体抗炎药(NSAIDs)会增加消化性溃疡的风险,并且在治疗开始1周内,志愿者的胃十二指肠黏膜糜烂即可得到证实。然而,非手术患者的长期研究并未记录到治疗第一周内出现胃十二指肠并发症。非甾体抗炎药围手术期(≥48小时且≤7天)治疗的对照研究累积数据并未提示在此时间段内胃十二指肠并发症(如出血/穿孔)风险增加。我们得出结论,长期使用非甾体抗炎药所记录的胃肠道副作用不应妨碍在术后使用非甾体抗炎药进行短期治疗以改善镇痛效果。