Con: Nonsteroidal anti-inflammatory drugs should not be routinely administered for postoperative analgesia after cardiac surgery

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) are nonspecific inhibitors of cyclooxygenase (COX), which is the rate-limiting enzyme involved in the synthesis of prostaglandins. COX exists in two forms: a constitutive form that is present in normal conditions in healthy cells (COX-1) and an inducible form (COX-2), which is the major isozyme induced by and associated with inflammation. NSAIDs are nonspecific inhibitors of both forms of COX, but they vary in their ratio of COX-1 to COX-2 inhibition. 1 Cashman J McAnulty G Nonsteroidal anti-inflammatory drugs in perisurgical pain management: Mechanisms of action and rationale for optimum use. Drugs. 1995; 49: 51-70 Crossref PubMed Scopus (90) Google Scholar COX-2 inhibitors more specifically inhibit the inducible form of the enzyme, leaving COX-1 activity intact. Two COX-2 inhibitors (celecoxib and rofecoxib) have been introduced in the United States.