Effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on morphine side effects in patient-controlled analgesia

In patient-controlled analgesia nonsteroidal anti-inflammatory drugs reduce opioid-related adverse effects such as post-operative nausea and vomiting and sedation, but not pruritus, urinary retention and respiratory depression.

A systematic review including 22 studies with a total of 2307 subjects (adults and adolescents older than 12 years undergoing orthopaedic and pelvic or abdominal surgery) was abstracted in DARE. NSAIDs compared to placebo decreased significantly postoperative nausea and vomiting (RR 0.70, 95% CI 0.59 to 0.84), nausea alone (RR 0.88, 95% CI 0.79 to 0.98), vomiting alone (RR 0.68, 95% CI 0.51 to 0.91) and sedation (RR 0.71, 95% CI 0.54 to 0.95, 10 studies) in post-operative patients receiving patient-controlled morphine-analgesia. The NNTs were 12 (95% CI 9 to 22), 16 (95% CI 9 to 108), 15 (95% CI 10 to 51), and 27 (95% CI 17 to 154), respectively. Reductions in post-operative nausea (P=0.007) and post-operative vomiting (P=0.02) were linearly related to the decrease in morphine consumption. Pruritus (8 studies), urinary retention (7 studies), and respiratory depression (8 studies) were not significantly decreased by NSAIDs.

Ədəbiyyat

1. Marret E, Kurdi O, Zufferey P, Bonnet F. Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology 2005 Jun;102(6):1249-60.