Risk/benefit evaluation of NSAIDs in postoperative pain therapy.

NSAIDs are effective analgesics with a clear role in the management of postoperative pain. Following major surgery they are part of a balanced approach to analgesia using a combination of different drugs and techniques. Additional clinical benefits include less drowsiness and lack of respiratory side effects. But as they moderately affect bleeding time, their use may not be appropriate following surgery when surgical control of bleeding cannot be guaranteed. These agents should also be administered with caution in elderly patients whom are at risk for renal dysfunction. NSAIDs have specific contraindications that preclude their use for postoperative pain therapy and which should be known by all anesthesiologists.