Gupta Anita, Bah Maimouna
Department of Anesthesiology and Pain Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
Curr Pain Headache Rep. 2016 Nov;20(11):62. doi: 10.1007/s11916-016-0591-7.
Postoperative pain results in multiple undesirable physiologic and psychological outcomes, and it should be managed in a multimodal approach. This article reviews the latest scientific literature of NSAIDs in the treatment of postoperative pain. The goal is to answer the following questions: (1) Are NSAIDs effective in the postoperative period? (2) Are NSAIDs safe in all surgical patients? and (3) Are adverse effects of NSAIDs increased or diminished in the acute postoperative period?
NSAIDs are safe and effective in the treatment of postoperative pain, and they should be administered to all postoperative surgical patients unless contraindicated. Based on literature, NSAIDs have been shown to increase patient satisfaction and decrease opioid requirements, minimizing opiate-induced adverse events. They have no increased incidence of adverse effects during the acute postoperative period. NSAIDs and COX-2 inhibitors, however, should be used with caution in colorectal surgery as they are proven to increase the risk of anastomotic leak.
术后疼痛会导致多种不良的生理和心理后果，应采用多模式方法进行管理。本文综述了非甾体抗炎药（NSAIDs）治疗术后疼痛的最新科学文献。目的是回答以下问题：（1）NSAIDs在术后阶段是否有效？（2）NSAIDs对所有手术患者是否安全？以及（3）NSAIDs的不良反应在术后急性期会增加还是减少？
NSAIDs在治疗术后疼痛方面安全有效，除非有禁忌证，所有术后手术患者均应使用。根据文献，NSAIDs已被证明可提高患者满意度并减少阿片类药物的需求，将阿片类药物引起的不良事件降至最低。它们在术后急性期不良反应的发生率并未增加。然而，NSAIDs和COX-2抑制剂在结直肠手术中应谨慎使用，因为已证实它们会增加吻合口漏的风险。
