NSAIDs Improve Postoperative Neurosurgical Pain Control

Addition of non-steroidal anti-inflammatory drugs decreases opioid use postoperatively

WEDNESDAY, July 9 (HealthDay News) -- Supplementing opioid analgesics in lumbar spine surgery with non-steroidal anti-inflammatory drugs (NSAIDs) provides better pain control than opioid analgesics alone, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

Kitti Jirarattanaphochai, M.D., Ph.D., and Surachai Jung, M.D., of the Khon Kaen University in Khon Kaen, Thailand, performed a meta-analysis to assess the efficacy and safety of an analgesic combination of NSAIDs plus opioids compared to opioid analgesics alone on perioperative pain management in lumbar spine surgery.

A total of 400 patients received NSAIDs plus opioid analgesics and 389 patients received opioid analgesics alone in 17 different studies, the researchers report. Patients receiving NSAIDs plus opioid analgesics consumed lower total doses of opioids (20 mg and 8 mg less at 24 and 48 hours, respectively) and had lower pain scores compared to patients receiving opioid analgesics alone, the investigators found. No differences in side effect event rates between the two treatments were noted.

"Our meta-analysis offers evidence that NSAIDs provide superior analgesia (reduced visual analog scale pain scores and reduced narcotic consumption) in comparison with conventional analgesia in patients undergoing lumbar spine surgery for discectomy or laminectomy and spinal fusion," the authors conclude. "Further well-designed, large, randomized trials are needed to confirm these findings."

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