Assignment: What are the surgical bleeding risks from taking NSAIDS

Assignment: What are the surgical bleeding risks from taking NSAIDS

Assignment: What are the surgical bleeding risks from taking NSAIDS

What are the surgical bleeding risks from taking NSAIDS

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Risks of Bleed from NSAIDS.

NSAID use for pain management is currently strongly advocated for as part of multimodal pain management strategies, which confers better pain management and reduces the use of opioids and their adverse effects on patients (Chang et.al., 2021). However, their use is not free of various drawbacks such as increased incidence of renal dysfunction, renal dysfunction, delayed wound and fracture healing, and gastrointestinal bleeding (Chang et.al., 2021).

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NSAIDS block ( COX-1) cyclooxygenase-1 and as a consequence inhibit thromboxane A2 that is needed for platelet aggregation. However, studies have generally been inconclusive regarding NSAID contraindication use post operatively (Varrassi et.al., 2020). Aside from aspirin, which irreversibly inhibits platelets, evidence present doesn’t support avoidance of other NSAIDS post-operative. Additionally, studies reveal they are generally safe even in use when performing plastic surgeries.

Few studies are present regarding effects such as acute gastrointestinal bleeding and ulcerations. Research reveals that increasedrisk of GI bleeding is predominantly linked to prolonged useof NSAIDS for pain relief. This is because of inhibited bicarbonate and mucus  secretion in the gastric mucosa. This risk can be reduced by use of NSAIDS for a short duration post operatively, with studies revealing a lower risk following less than 7-day regimen of ibuprofen (Varrassi et.al., 2020). Based on the mechanism of action of NSAIDS, peri-operative bleeding is a major concern following their use for pain management. As such, their use should be patient-centred in order to identify any risk factors that would predispose the patient to bleeding risk.

References

Chang, R. W., Tompkins, D. M., & Cohn, S. M. (2021). Are NSAIDs safe? Assessing the risk-benefit profile of nonsteroidal anti-inflammatory drug use in postoperative pain management. The American Surgeon, 87(6), 872-879.https://doi.org/10.1177/0003134820952834

Varrassi, G., Pergolizzi, J. V., Dowling, P., & Paladini, A. (2020). Ibuprofen safety at the golden anniversary: are all NSAIDs the same? A narrative review. Advances in therapy, 37, 61-82.https://link.springer.com/article/10.1007/s12325-019-01144-9

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