Nonsteroidal Anti-inflammatory Drugs

Paulasir, Sylvester; Kaoutzanis, Christodoulos; Welch, Kathleen B.; Vandewarker, James F.; Krapohl, Greta L.; Lampman, Richard M.; Franz, Michael; Cleary, Robert K.

doi:10.1097/dcr.0000000000000430

Cited by 50 publications

(8 citation statements)

References 14 publications

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“…In a study by Gorissen et al, patients on NSAIDs had higher anastomotic leakage rates than those not treated with NSAIDs (13.2% versus 7.6%; p = 0.010) [ 54 ]. However, a multicenter retrospective study found no statistically significant increase in the proportion of patients with anastomotic leak when prescribing nonsteroidal anti-inflammatory drugs for analgesia in the early postoperative period for patients undergoing elective colorectal surgery [ 55 ]. This finding is supported by other studies, showing that use of NSAIDs did not increase the risk of anastomotic leakage after anterior resection for rectal cancer [ 56 , 57 ].…”

Section: Preoperative Risk Factorsmentioning

confidence: 99%

Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery

Zarnescu

Costea

2021

Diagnostics

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Anastomotic leakage is a potentially severe complication occurring after colorectal surgery and can lead to increased morbidity and mortality, permanent stoma formation, and cancer recurrence. Multiple risk factors for anastomotic leak have been identified, and these can allow for better prevention and an earlier diagnosis of this significant complication. There are nonmodifiable factors such as male gender, comorbidities and distance of tumor from anal verge, and modifiable risk factors, including smoking and alcohol consumption, obesity, preoperative radiotherapy and preoperative use of steroids or non-steroidal anti-inflammatory drugs. Perioperative blood transfusion was shown to be an important risk factor for anastomotic failure. Recent studies on the laparoscopic approach in colorectal surgery found no statistical difference in anastomotic leakage rate compared with open surgery. A diverting stoma at the time of primary surgery does not appear to reduce the leak rate but may reduce its clinical consequences and the need for additional surgery if anastomotic leakage does occur. It is still debatable if preoperative bowel preparation should be used, especially for left colon and rectal resections, but studies have shown similar incidence of postoperative leak rate.

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Section: Preoperative Risk Factorsmentioning

confidence: 99%

Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery

Zarnescu

Costea

2021

Diagnostics

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“…The physicians are also encouraged to use the lowest effective dose for the shortest duration of a selective COX-2 inhibitor. In surgical point of view, the use of any NSAIDs including selective COX-2 inhibitors in the setting of gastrointestinal anastomosis has been concerned because some studies have suggested that NSAIDs may impair anastomotic healing [38][39][40] . Recently, a meta-analysis of clinical and experimental studies in 2014 has indicated a strong link between anastomotic leakage and the use of non-selective NSAIDs, but not the use of selective COX-2 inhibitors [41] .…”

Section: Discussionmentioning

confidence: 99%

Opioid-sparing effect of selective cyclooxygenase-2 inhibitors on surgical outcomes after open colorectal surgery within an enhanced recovery after surgery protocol

Lohsiriwat

2016

Clinical Nutrition ESPEN

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“…Findings related to the risks of anastomotic leak in bowel surgery in relation to the use of NSAIDs are conflicting (Hakkarainen et al 2015, Paulasir et al 2015). Although some studies reported an increased frequency of anastomotic leak in patients treated with nonselective NSAIDs and decreased anastomotic leak with the use of selective COX-2 inhibitors, the effects of NSAIDs remain unclear.…”

Section: Multimodal Analgesiamentioning

confidence: 99%

Overview of multimodal analgesia initiated in the perioperative setting

Tubog

2020

Journal of Perioperative Practice

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Despite progress in pain management in the perioperative setting, the literature is full of evidence that managing postoperative pain is suboptimal. Since the mechanism of pain is complex, the use of multimodal technique allows clinicians to use a combination of two or more drugs targeting different areas of pain transmission because of surgery. As part of enhanced recovery initiatives after surgery, healthcare and professional organisations incorporate the use of multimodal analgesia in surgical guidelines to improve patient satisfaction. This review aims to understand and summarise the current body of evidence involving the most common pharmacological therapies to manage postoperative pain in the preoperative setting.

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Nonsteroidal Anti-inflammatory Drugs

Cited by 50 publications

References 14 publications

Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery

Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery

Opioid-sparing effect of selective cyclooxygenase-2 inhibitors on surgical outcomes after open colorectal surgery within an enhanced recovery after surgery protocol

Overview of multimodal analgesia initiated in the perioperative setting

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