NSAIDs for Pain Control During the Peri-Operative Period of Hip Fracture Surgery: A Systematic Review.

Bibliographic Details
Title: NSAIDs for Pain Control During the Peri-Operative Period of Hip Fracture Surgery: A Systematic Review.
Authors: Pommier, Wilhelm, Minoc, Elise-Marie, Morice, Pierre-Marie, Lescure, Pascale, Guillaume, Cyril, Lafont, Claire, Fischer, Marc-Olivier, Boddaert, Jacques, Thietart, Sara, Lelong-Boulouard, Véronique, Beauplet, Bérengère, Villain, Cédric
Source: Drugs & Aging; Feb2024, Vol. 41 Issue 2, p125-139, 15p
Subject Terms: NONSTEROIDAL anti-inflammatory agents, MEDICAL information storage & retrieval systems, HIP fractures, TREATMENT effectiveness, SYSTEMATIC reviews, MEDLINE, PAIN management, PAIN, MEDICAL databases, ONLINE information services, PERIOPERATIVE care, EVALUATION
Abstract: Background: Hip fracture (HF) mostly affects older adults and is responsible for increased morbidity and mortality. Non-steroidal anti-inflammatory drugs (NSAIDs) are part of the peri-operative multimodal analgesic management, but their use could be associated with adverse events in older adults. This systematic review aimed to assess outcomes associated with NSAIDs use in the peri-operative period of HF surgery. Methods: This systematic review was conducted according to the PRISMA guidelines. Three databases (PubMed/EMBASE/Cochrane Central) were used to search for clinical trials and observational studies assessing efficacy, safety and impact of NSAIDs use on non-specific post-operative outcomes, such as functional status and post-operative complications. Results: Among the 1320 references initially identified, four provided data on efficacy, four on safety and six on non-specific post-operative outcomes (three randomized controlled clinical trials, three observational studies). Mean study population ages ranged from 68 to 87 years. Two studies found that NSAIDs were effective on pain control, but two studies found conflicting results on opioid sparing. No increased risk of acute kidney injury was observed, while results concerning bleeding risk and delirium were conflicting. No study has found any effect of NSAIDs use on walk recovery. Quality of evidence was high for pain control, but low to very low for all the other studied outcomes. Conclusions: The use of NSAIDs may be effective for pain control in the peri-operative period of HF surgery. However, safety data were conflicting with low levels of certainty. Further studies are needed to assess their benefit–risk balance in this context. The research protocol was previously registered on PROSPERO (registration number: CRD42021237649) [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
More Details
ISSN:1170229X
DOI:10.1007/s40266-023-01074-w
Published in:Drugs & Aging
Language:English