This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Huang, J. Search for Related Content PubMed PubMed Citation Articles by Huang, J.

---

LETTER TO THE EDITOR

Efficacy of the NSAIDs Depends on Multiple Factors

Anesthesiologists of Greater Orlando; Orlando, FL; jeffrey_j_huang{at}hotmail.com

To the Editor:

Karamanlioglu et al. (1) found that preoperative administration of oral rofecoxib reduced tramadol consumption for treatment of postoperative pain after hysterectomy. In a similar study, Huang et al. (2) did not find a rofecoxib-induced reduction in pain score or morphine consumptions in patients after radical prostatectomy. Different surgical incision between the Karamanlioglu et al. (1) and Huang et al. (2) studies may account for the differing results. Midline infraumbilical incision was used when radical prostatectomywas performed in the Huang et al. (2) study. Transverse incision was used in the Karamanlioglu et al. (1) study. A meta-analysis indicated that the transverse incision results in significantly less postoperative pain (3). However, in surgical practice the midline incision is still mainly used (4). Surgeons’ main interests are as follows: time to open and close the abdomen and frequency of burst abdomen, the quick and optimal exposure of the operative field, wound infection, postoperative pulmonary complications, and incision hernias (4).

The efficacy of the nonsteroidal antiinflammatory drugs (NSAIDs) also depends on type of surgical procedure and patient population. Fredman et al. (5) studied a homogenous male population undergoing transvesical prostatectomy and found no difference in postoperative pain score or morphine consumption between patients receiving ketorolac and saline. In contrast, Parker et al. (6) studied a homogenous female population undergoing lower abdominal surgery and found that ketorolac provided significant analgesic benefit and decreased morphine consumption.

The efficacy of the NSAIDs depends on multiple factors such as surgical incision, type of surgical procedure, and patient population.

References

1. Karamanlioglu B, Tyran A, Memis D, et al. Preoperative oral rofecoxib reduces postoperative pain and tramadol in patients after abdominal hysterectomy. Anesth Analg 2004;98:1039–43.[Abstract/Free Full Text]
2. Huang JJ, Taguchi A, Hus H, et al. Preoperative oral rofecoxib does not reduce postoperative pain or morphine consumption in patients after radical prostatectomy. J Clin Anesth 2001;13:94–7.[Web of Science][Medline]
3. Grantcharov TP, Rosenberg J. Vertical compared with transverse incisions in abdominal surgery. Eur J Surg 2001;167:260–7.[Web of Science][Medline]
4. Reidel MA, Knaebel HP, Seiler CM, et al. Postsurgical pain outcome of vertical and transverse abdominal incision: design of a randomized controlled equivalence trial. BMC Surg 2003;3:9.[Medline]
5. Fredman B, Olsfanger D, Flor P, et al. Ketorolac does not decrease postoperative pain in elderly men after transvesical prostatectomy. Can J Anaesth 1996;43:438–41.
6. Parker RK, Holtmann B, Smith I, et al. Use of Ketorolac after lower abdominal surgery. Anesthesiology 1994;80:6–12.[Web of Science][Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Huang, J. Search for Related Content PubMed PubMed Citation Articles by Huang, J.