Key result
Postoperative use of NSAIDs for less than 2 weeks is not precluded by current limited human data, though well-designed large RCTs are required to provide definitive answers on healing.
Why the study?
While NSAIDs are an important component of multimodal perioperative analgesia, there has been ongoing debate regarding their potentially harmful effects on tissue healing after surgery and trauma.
Do NSAIDs interfere with healing after surgery?
Do NSAIDs interfere with healing after surgery?
Current limited human evidence does not preclude the short-term use (<2 weeks) of NSAIDs for postoperative analgesia, despite theoretical concerns regarding impaired healing.
Short-term postoperative NSAIDs may be acceptable; leaves open definitive healing effects pending larger RCTs.
Perioperative analgesia should be multimodal to improve pain relief, reduce opioid use and thereby adverse effects impairing recovery. Non-steroidal anti-inflammatory drugs (NSAIDs) are an important non-opioid component of this approach. However, besides potential other adverse effects, there has been a longstanding discussion on the potentially harmful effects of NSAIDs on healing after surgery and trauma. This review describes current knowledge of the effects of NSAIDs on healing of bones, cartilage, soft tissue, wounds, flaps and enteral anastomoses. Overall, animal data suggest some potentially harmful effects, but are contradictory in most areas studied. Human data are limited and of poor quality; in particular, there are only very few good randomized controlled trials (RCTs), but many cohort studies with potential for significant confounding factors influencing the results. The limited human data available are not precluding the use of NSAIDs postoperatively, in particular, short-term for less than 2 weeks. However, well-designed and large RCTs are required to permit definitive answers.
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Stephan A. Schug (2021) conducted a review in Healing after surgery and trauma. Non-steroidal anti-inflammatory drugs (NSAIDs) was evaluated on Healing of bones, cartilage, soft tissue, wounds, flaps and enteral anastomoses. Postoperative use of NSAIDs for less than 2 weeks is not precluded by current limited human data, though well-designed large RCTs are required to provide definitive answers on healing.
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