Continuous intravenous diclofenac does not induce opioid-sparing or improve analgesia in geriatric patients undergoing major orthopedic surgery

Perioperative Opioid-sparing Strategies: Utility of Conventional NSAIDs in Adults

“…All included trials were conducted in adult populations aged 18 years or older, and 1 study was conducted specifically in a geriatric population over 65 years of age. 19 All studies were conducted in the surgical setting, and common surgeries in the trials reviewed included gynecologic surgery/cesarean delivery (n = 15), 12,13,18,[20][21][22][23][24][25][26] orthopedic/arthroscopic surgery (n = 10), 11,14,19,[27][28][29][30][31][32][33] and spinal surgery (n = 4). [34][35][36][37] Findings from individual NSAIDs are presented below.…”

Continuous Infusion Ketorolac for Postoperative Analgesia Following Unilateral Total Knee Arthroplasty

“…CI NSAIDs have been studied within diverse orthopedic surgical populations. [13][14][15][16][17][18][19][20]26 Comparisons of CI NSAIDs to alternative treatment regimens have shown similar pain control and opioid consumption. However, many of these studies were in patients undergoing total hip arthroplasty (THA) or other orthopedic procedures, or the authors did not report which type of orthopedic surgery was performed.…”

“…However, many of these studies were in patients undergoing total hip arthroplasty (THA) or other orthopedic procedures, or the authors did not report which type of orthopedic surgery was performed. [13][14][15]19,20,26 In studies reporting TKA, these patients only comprised 36% of orthopedic surgical patients enrolled. [16][17][18] To date, there has been only 1 other study that evaluated the use of CI ketorolac for management of postoperative pain following arthroplasty, TKA, and THA.…”

Making Progress in the Management of Postoperative Pain: A Review of the Cyclooxygenase 2–Specific Inhibitors

“…32,[45][46][47][48][49][50][51][52][53][54][55][56][57][58] Other studies have not shown a clear benefit of adding NSAIDs to the standard opioid pain management, although these were generally studies in which the NSAID was given one time before surgery and not continued after surgery. 44,45,53,54,[59][60][61][62][63][64][65] Nevertheless, NSAIDs still play a role as part of a balanced multimodal analgesic approach and may have particular value for major surgical procedures. [66][67][68] These major surgical procedures (e.g., cardiac, orthopedic) represent a significant pain management challenge for which a combination of agents including NSAIDs is often required to maximize pain relief.…”