Nonsteroidal Anti-Inflammatory Drugs and Bone-Healing

Marquez-Lara, Alejandro; Hutchinson, Ian D.; Nuñez, Fiesky A.; Smith, Thomas L.; Miller, Anna N.

doi:10.2106/jbjs.rvw.o.00055

Cited by 105 publications

(76 citation statements)

References 104 publications

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“…10,23,24 Withholding NSAIDs may also increase the need for opioids to deal with pain, increasing opioid exposure and risks. 25 Opioids were commonly prescribed in our study with 81% of charts containing an opioid order. There was no significant difference in the percentage of opioids prescribed for minor, intermediate and major surgery (p = 0.178).…”

Section: Discussionmentioning

confidence: 83%

Paediatric postoperative analgesia prescribing report card: “could do better”

Bösch

CronjÃ

Vasconcellos

et al. 2019

South Afr J Anaesth Analg

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Background: A key element of paediatric pain management is prescribing and dispensing analgesia. This process differs in children, putting them at greater risk of drug error. Methods: This study was a retrospective postoperative analgesia prescription chart review of children who had orthopaedic surgery in a tertiary hospital in Durban, South Africa. Patient records of 202 children, aged 6 months to 12 years, with 232 theatre visits were reviewed. Prescription charts were inspected for patient characteristics, evidence of good prescribing practice and data regarding the prescribing and administration of analgesia. Results: Of the 257 analysed charts 254 (99%) had paracetamol, 208 (81%) had an opioid and 49 (19%) had a nonsteroidal antiinflammatory drug (NSAID) prescribed. Underdosing was evident in all groups of analgesics prescribed. Opioids were more often prescribed with a pro-re-nata caveat and were the least correctly dispensed. There were no prescription charts in which all the requirements for good prescribing practice were complete. Conclusions: This study demonstrates a high rate of paediatric drug error in both the prescribing and dispensing of analgesia. Potential under-utilisation of NSAIDs in this orthopaedic population is also noted. Lack of knowledge or confidence needed by clinicians to adhere to principles of paediatric dosing and multimodal analgesia may be contributing factors. Issues pertaining to paediatric analgesia prescribing and dispensing are highlighted and should be targeted by institution and population specific interventions.

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Section: Discussionmentioning

confidence: 83%

Paediatric postoperative analgesia prescribing report card: “could do better”

Bösch

CronjÃ

Vasconcellos

et al. 2019

South Afr J Anaesth Analg

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“…26 Other systemic reviews of the literature have been inconclusive. 27 This remains an area of active research with no definitive conclusions despite the volume of literature on this topic.…”

Section: Nsaidsmentioning

confidence: 99%

Peri- and Postoperative Pain Management in Multiple Ligament Knee Surgery in the Hospital and Ambulatory Surgery Center Setting

Fanelli

2019

J Knee Surg

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The multiligament knee injury presents as a complex injury pattern that has substantial potential to cause long-term disability. Patients who sustain this injury pattern experience significant pain not only immediately following injury but also throughout the perioperative and postoperative period. Treating pain with major orthopaedic procedures is challenging but technical success of a surgical repair becomes trivial when pain is not effectively managed. This article will (1) provide an outline of the types of pain most often sustained in the multiligament knee injury, (2) outline the phases of pain management for this injury, and (3) provide an overview of persistent postoperative pain. The principles of multimodal analgesia in combination with effective regional anesthesia and attentive intraoperative management can position patients for successful rehabilitation and recovery.

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“…Weitere Ansätze wie die medikamentöse Blockierung spezifischer Signalwege, die für den Knochenabbau relevant sind, oder die Transplantation autologer CD34 + -Granulozyten auf eine lokal applizierte Matrix haben das experimentelle Stadium noch nicht verlassen, könnten aber möglicherweise zukünftig interessant werden [52 -54]. Den häufig eingesetzten, nicht steroidalen antiinflammatorischen Medikamenten (NSAIDs) wird ein negativer Effekt auf die Frakturheilung nachgesagt, eine abschließende Bewertung ist allerdings weiterhin aufgrund der widersprüchlichen Datenlage nicht möglich [55].…”

Section: Differenzierte Indikationunclassified

Pseudarthrosen am Unterarm

Rausch¹,

Hackl²,

Ries³

et al. 2019

OP-JOURNAL

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ZusammenfassungUnterarmfrakturen treten häufig auf und werden regelhaft operativ versorgt. Für gute funktionelle Ergebnisse müssen Unterarmfrakturen anatomisch reponiert werden, was im Falle einer Revision weiter erschwert wird. Daher ist eine ausbleibende Frakturheilung bei diesen Verletzungen besonders problematisch.Die operative Therapie dieser Pseudarthrosen besteht aus einem Debridement und der stabil osteosynthetischen Versorgung. In der Regel ist zudem eine Augmentation des knöchernen Defekts erforderlich: Kleinere Defekte können erfolgreich mit einer Spongiosaplastik behandelt werden, für größere Defekte werden vaskularisierte und nicht vaskularisierte Späne verwendet. In seltenen Ausnahmen können auch Reserveverfahren wie der Segmenttransport oder das Masquelet-Verfahren Anwendung finden. Mit diesen Strategien ist meist eine erfolgreiche Ausheilung der Pseudarthrose möglich. Ziel dieses Artikels ist die Häufigkeit von Pseudarthrosen am Unterarm und Therapiestrategien zusammenzufassen.

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Nonsteroidal Anti-Inflammatory Drugs and Bone-Healing

Cited by 105 publications

References 104 publications

Paediatric postoperative analgesia prescribing report card: “could do better”

Paediatric postoperative analgesia prescribing report card: “could do better”

Peri- and Postoperative Pain Management in Multiple Ligament Knee Surgery in the Hospital and Ambulatory Surgery Center Setting

Pseudarthrosen am Unterarm

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