ArticleTrauma surgery & acute care open2023
Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma and the Orthopedic Trauma Association.
Article in Trauma surgery & acute care open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Analgesic effect of premixed nitrous oxide in postoperative rehabilitation for ankle fractures: a randomized controlled trial.Annals of medicine · 2026Trial
- Effect of perioperative multistrain probiotics on the CT callus volume fraction at 12 weeks after surgery for closed tibial shaft fracture: a single-center randomized controlled study.Frontiers in cellular and infection microbiology · 2026Trial
- Postoperative Intravenous Ketorolac Does Not Affect Nonunion Risk in Surgically Treated Long Bone Shaft Fractures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Nonunion of metacarpal fractures associated with NSAID use: a case report.International journal of surgery case reports · 2026Article
- Effect of nonsteroidal anti-inflammatory drugs on union, opioid utilization, and pain management for tibial fractures (NSAID Trial): a pragmatic randomized clinical trial protocol.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Mitochondria as Inducers of Neutrophil Extracellular Traps.Inflammation · 2026Review
- Regional, multimodal, and opioid-sparing strategies after trauma: a review.Trauma surgery & acute care open · 2026Review
- Impact of NSAIDs on post-operative bleeding in minor dental and oral surgery: A clinical study.Bioinformation · 2026Article
- Prevalence, predictors, and clinical relevance of drug-drug interactions in outpatient prescribing: A national cross-sectional study.PloS one · 2026Article
- Assessment of non-steroidal anti-inflammatory drugs use and its complications among pediatric patients at a private tertiary care hospital in Malaysia.BMC pediatrics · 2025Article
- Short-Term Celecoxib Promotes Bone Formation without Compromising Cefazolin Efficacy in an Early Orthopaedic Device-Related Infection: Evidence from a Rat Model.Antibiotics (Basel, Switzerland) · 2024Article
- Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune-Inflammatory-Metabolic Markers and Related Conceptual Issues.Journal of clinical medicine · 2024Article
- Consumer awareness and knowledge regarding use of non-steroidal anti-inflammatory drugs (NSAIDs) in a metropolitan area.Frontiers in pharmacology · 2024Article
- Opioid and non-opioid analgesic regimens after fracture and risk of serious opioid-related events.Trauma surgery & acute care open · 2024Article
- Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review.Life (Basel, Switzerland) · 2023Review
- Comparison of Acute Pain Syndrome after Surgical Interventions in the Nasal Cavity and Rhinoplasty.Doklady. Biochemistry and biophysics · 2023Article
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established. Methods: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations. Results: A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use. Conclusions: In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks.
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