NSAID's

[oper_wick]

Rember guys I am new to this game. If it is not on a crash cart I sometimes do not follow. Realy it is not that bad but I have a question about Toradol. I read a post here somewhere about not using it post op. Would that be for all practices or just major ortho surg. The rational I seen was that fractures needed inflamtion to heal and with the NSAID you could end up with a non union. I am looking for the science answer not the protocal answer, maybe some type of study or modality path. I have seen it used for up to 72 hours after scopes and such, never after a total knee type surg. Give me some tips please.

Thanks,

Oper_Wick

[SusanJean]

NSAID's inhibit the inflammatory response...so if it is needed, you don't want to administer NSAID's.

Inflammation is our body's response to injury/invasion. It would make sense, post-op ortho that you need an active inflam. response to help heal. Also, if someone has a fever, it is not necessarily the best thing to use an NSAID for pain tx if you need to monitor the fever, or let it work as nature intended.

Many NSAIDs have anti-coag. properties, so they are often avoided post op or post fracture.

[Kudra]

as Susan Jean said, the main reasons some orthopods don't like NSAIDS is because of the antinflamatory properties and the anticoagulant properties... it's usually surgeon's preference and you can pretty much gain a good idea for how they feel by looking at the prn's they order post-op...

[P_RN, ADN, RN]

To prevent aseptic loosening of your artificial joint you should follow this simple advice: do not overload your artificial joint.

I should also mention the ongoing drug trials to prevent the development of prosthetic loosening: NSAID drugs and biphosphonate drugs.

The NSAID drugs are supposed to mitigate the inflammatory reaction caused by wear particles. Some studies indicate, however, that NSAID accelerate the development of osteolysis.

http://www.totaljoints.info/TKNEE_loose_details.htm

The biphosphonate drugs are supposed to make the bone substance more resistant to destruction by inflammatory cells. (Archibeck 2000). In one such rare study, the patients on biphosphopnate drugs have had lesser bone loss than other total hip patients (sorry, no total knee studies published as yet) .

I have seen some UK studies that hope to refute the need to avoid NSAIDs. Always there is the problem of GI bleeding with NSAIDs.

[akcarmean, LPN]

I have been given it for a migraine before IV, pill, and IM form

[P_RN, ADN, RN]

It is a miracle drug as far as migraine!!!