Display options
Cite
Bernthal NM, Hart CM, Sheth KR, et al. Local and Intra-articular Administration of Nonsteroidal Anti-inflammatory Drugs for Pain Management in Orthopedic Surgery. Am J Ther. 2020;doi: 10.1097/MJT.0000000000001309.
Bernthal, N. M., Hart, C. M., Sheth, K. R., Bergese, S. D., Ho, H. S., Apfel, C. C., Stoicea, N., Rojhani, A., & Jahr, J. S. (2020). Local and Intra-articular Administration of Nonsteroidal Anti-inflammatory Drugs for Pain Management in Orthopedic Surgery. American journal of therapeutics, . https://doi.org/10.1097/MJT.0000000000001309
Bernthal, Nicholas M, et al. "Local and Intra-articular Administration of Nonsteroidal Anti-inflammatory Drugs for Pain Management in Orthopedic Surgery." American journal of therapeutics vol. (2020). doi: https://doi.org/10.1097/MJT.0000000000001309
Bernthal NM, Hart CM, Sheth KR, Bergese SD, Ho HS, Apfel CC, Stoicea N, Rojhani A, Jahr JS. Local and Intra-articular Administration of Nonsteroidal Anti-inflammatory Drugs for Pain Management in Orthopedic Surgery. Am J Ther. 2020 Dec 10; doi: 10.1097/MJT.0000000000001309. Epub 2020 Dec 10. PMID: 33315593.
Copy Download .nbib Format: NLM
Share it on

Am J Ther. 2020 Dec 10; doi: 10.1097/MJT.0000000000001309. Epub 2020 Dec 10.

Local and Intra-articular Administration of Nonsteroidal Anti-inflammatory Drugs for Pain Management in Orthopedic Surgery.

American journal of therapeutics

Nicholas M Bernthal, Christopher M Hart, Ketan R Sheth, Sergio D Bergese, Hung S Ho, Christian C Apfel, Nicoleta Stoicea, Allen Rojhani, Jonathan S Jahr

Affiliations

  1. Department of Orthopaedic Surgery, University of California Los Angeles David Geffen School of Medicine, UCLA Medical Center, Santa Monica, CA.
  2. Department of General Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA.
  3. Department of Anesthesiology, School of Medicine, Stony Brook University, Health Sciences Center, Stony Brook, NY.
  4. Department of Surgery, University of California Davis, Sacramento, CA.
  5. Department of Epidemiology and Biostatistics, University of California San Francisco, CA.
  6. Department of Biological Chemistry and Pharmacology, Ohio State University, Columbus, OH.
  7. Drexel University College of Medicine, Philadelphia, PA.
  8. Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles David Geffen School of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA.

PMID: 33315593 DOI: 10.1097/MJT.0000000000001309

Abstract

BACKGROUND: Although growing evidence demonstrates the benefits of locally administered nonsteroidal anti-inflammatory drugs (NSAIDs) for postoperative pain management, there is ongoing debate regarding NSAID use in orthopedic surgery.

AREAS OF UNCERTAINTY: Current data largely support a local site of NSAID action and suggest that effective pain control can be achieved with delivery of NSAIDs intra-articularly (IA) and/or locally at the site of injury, where they can block peripheral production of inflammatory mediators and may desensitize nociceptors. Improvements in postoperative pain control with locally administered NSAIDs have been widely reported in the total joint arthroplasty literature and may offer benefits in patient's undergoing arthroscopic procedures and those with osteoarthritis as well. The purpose of this review is to examine the available evidence in the literature regarding the efficacy and safety profile of the use of local and IA NSAIDs in orthopedic surgery.

DATA SOURCES: Narrative literature review using keywords, expert opinion, either during or from live conference.

THERAPEUTIC ADVANCES: Local and IA administration of NSAIDs for pain management in orthopedic surgery.

CONCLUSION: There is convincing evidence that NSAIDs administered locally in and around the joint reduce postoperative pain scores and opioid consumption in patients undergoing total joint arthroplasty, yet further research is required regarding the risks of potential chondrotoxicity and the inhibition of bone and soft-tissue healing with locally administered NSAIDs.

Publication Types