Immune Modulatory Effects of Nonsteroidal Anti-inflammatory Drugs in the Perioperative Period and Their Consequence on Postoperative Outcome

Background: Postoperative pain management is crucial for aesthetic plastic surgery procedures. Poorly controlled postoperative pain results in negative physiologic effects and can affect length of stay and patient satisfaction. In light of the growing opioid epidemic, plastic surgeons must be keenly familiar with opioid-sparing multimodal analgesia regimens to optimize postoperative pain control. Methods: A review study based on multimodal analgesia was conducted. Results: We present an overview of pain management strategies pertaining to aesthetic plastic surgery and offer a multimodal analgesia model for outpatient aesthetic surgery practices. Conclusion: This review article presents an evidence-based approach to multimodal pain management for aesthetic plastic surgery.

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“…34 In contrast, COX-2 specific inhibitors do not have any effects on COX-1 enzymes and thus do not influence platelet function. 35…”

Section: Nsaids and Cyclo-oxygenase (Cox)-2 Specific Inhibitorsmentioning

confidence: 99%

Multimodal Analgesia in the Aesthetic Plastic Surgery: Concepts and Strategies

Schoenbrunner

Joshi

Janis

2022

Plastic and Reconstructive Surgery - Global Open

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“…F2a result in the sensitization of nociceptive nerve fibres to painful stimuli following tissue injury, NSAIDs cause a reduction in their synthesis and therefore analgesia [7].…”

Section: Tablementioning

confidence: 99%

Perioperative Analgesia in Caesarean Section: What’s New?

Saucillo-Osuna¹,

Wilson-Manríquez²,

López-Hernández³

et al. 2023

Topics in Postoperative Pain

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Caesarean section is associated with moderate to severe postoperative pain during the first 24 hours after surgery. Inadequate pain management can influence recovery, maternal psychological well-being and breastfeeding. In the search of alternatives to minimize the use of systemic opioids, new recommendations have been made to implement protocols to improve recovery after caesarean section, with multimodal analgesia, new suggestions for neuraxial techniques, regional analgesia with ultrasound-guided fascial plane blocks and non-pharmacological approaches. Some of the interventions, such as epidural or spinal blocks, although effective, carry a significant risk of complications (for example post-puncture headache). In their place, newer alternatives such as interventions guided by ultrasound are safe and effective for relieving pain in this common clinical context. The goal of this chapter is to provide clinicians with up-to-date evidence for optimal pain management after elective caesarean section.

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“…8 Additionally, the surgical stress creates an inflammatory response which leads to increased pain. 9 Given that the pain mechanisms are complex, and use a variety of signalling systems, a multimodal analgesic treatment approach is recommended to achieve optimal pain relief. 8 Postoperative pain treatment aims to improve patient comfort, postoperative morbidity, rehabilitation, early mobilisation, quality of life and discharge readiness.…”

Section: Postoperative Painmentioning

confidence: 99%

“…The excitability of the central neurons can be decreased and peptides can be regulated so the experienced pain is less intense 8 . Additionally, the surgical stress creates an inflammatory response which leads to increased pain 9 . Given that the pain mechanisms are complex, and use a variety of signalling systems, a multimodal analgesic treatment approach is recommended to achieve optimal pain relief 8 …”

Section: Introductionmentioning

confidence: 99%

Risk of serious adverse events associated with non‐steroidal anti‐inflammatory drugs in orthopaedic surgery. A protocol for a systematic review

Leth

Bukhari

Laursen

et al. 2022

Acta Anaesthesiol Scand

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Background: Postoperative pain is a common condition following orthopaedic surgeries and causes prolonged hospitalisation, delayed rehabilitation and hamper the quality of life. Non-steroidal anti-inflammatory drugs (NSAIDs) are effective analgesics and anti-inflammatory mediators in the treatment of postoperative pain. The association of NSAIDs with serious adverse events may however keep some clinicians and clinical decision makers from using NSAIDs perioperatively. The evidence regarding the risks of serious adverse events following perioperative use of NSAIDs in orthopaedic surgery is sparse and needs to be assessed in a systematic review. This is a protocol for a systematic review that aims to identify the risks of serious adverse events from perioperative use of NSAIDs in orthopaedic patients.Methods: Our methodology is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the eight-step assessment procedure suggested by Jakobsen and colleagues. We wish to assess if NSAIDs versus placebo, usual care or no intervention, will influence the risks of serious adverse events in patients undergoing orthopaedic surgery. We will include all randomised trials assessing the use of NSAIDs perioperatively. To identify trials we will search the Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cochrane Central Register, Science Citation Index Expanded on Web of Science and BIOSIS. Two authors will screen the literature and extract data. We will use the 'Risk of Bias 2 tool' to assess trials. Extracted data will be analysed using RStudio and Trial Sequential Analysis. We will create a 'Summary of Findings' table in which we will present our primary and secondary outcomes. We will assess the quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Discussion: This systematic review can potentially aid clinicians and clinical decision makers in the use of NSAIDs for treatment of postoperative pain following orthopaedic surgeries.

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Immune Modulatory Effects of Nonsteroidal Anti-inflammatory Drugs in the Perioperative Period and Their Consequence on Postoperative Outcome

Cited by 25 publications

References 159 publications

Multimodal Analgesia in the Aesthetic Plastic Surgery: Concepts and Strategies

Multimodal Analgesia in the Aesthetic Plastic Surgery: Concepts and Strategies

Perioperative Analgesia in Caesarean Section: What’s New?

Risk of serious adverse events associated with non‐steroidal anti‐inflammatory drugs in orthopaedic surgery. A protocol for a systematic review

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