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LETTER TO THE EDITOR

Preemptive Analgesia by Nonsteroidal Antiinflammatory Drugs

Department of Anesthesiology and; Pain Treatment; University Hospital Maastricht; Maastricht, the Netherlands; mmar{at}sane.azm.nl

In Response:

We agree completely with Adachi et al. (1) that nonsteroidal antiinflammatory drugs (NSAIDs) are very useful in the context of a multimodal concept of postoperative analgesia. In our study the combination of preoperative piroxicam and postoperative tramadol resulted in very low postoperative pain scores (2). It is unclear whether the analgesia was a primary effect, or was secondary to preemptive analgesia as Adachi et al. suggest. However, when using perioperative NSAIDs one should bear in mind contraindications to their use, and the increase in adverse effects with prolonged therapy and in the elderly (3).

REFERENCES

1. Sano H, Doi M, Sato S. Preemptive analgesia by nonsteroidal antiinflammatory drugs. Anesth Analg 2006;103:
2. Gramke HF, Petry JJ, Durieux ME, et al. Sublingual piroxicam for postoperative analgesia: preoperative versus postoperative administration. A randomized, double-blind study. Anesth Analg 2006;102:755–8.[Abstract/Free Full Text]
3. Joshi GP. Multimodal analgesia techniques and postoperative rehabilitation. Anesthesiol Clin North America 2005;23:185–202.[Medline]

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