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Study shows some pain medication slows healing after surgery

Posted on: November 11th, 2013 by Ortho Illinois

[quote]“It’s a complicated answer for a straightforward question because patients often have other factors which need to be taken into account,” – Scott Trenhaile, MD.[/quote]

A recent study conducted by doctors at the Hospital for Special Surgery found that Indomethacin and Celecoxib (two non-steroidal anti-inflammatory drugs or NSAIDS) negatively affect healing after rotator cuff surgery. The drugs specifically affected the time necessary for tendon-to-bone healing.

Scott Trenhaile, MD, sports medicine with Rockford Orthopedic, said, “We do use NSAIDS perioperatively (during surgery), but we only use them in a very limited fashion to get patients through the most intense period of the surgical experience.”

Dr. Trenhaile uses an older NSAID called Toradol, and he doesn’t have any issues with its use because hardly any healing takes place for the first few days after surgery. NSAIDS do reduce the need for narcotics after surgery.

“It’s easier to control pain than to catch up with pain. That’s why NSAIDS exist,” said Dr. Trenhaile. NSAIDS also work to control inflammation during surgery.

The problem is that patients are never pain free after surgery unless a regional block is used

Other medications also hinder healing after surgery, but according to Dr. Trenhaile, they don’t get the same press. Immune system suppressants also do this, which can cause problems for patients with arthritis.

Dr. Trenhaile did acknowledge that the studies on NSAIDS are improving. In the past, many physicians dismissed findings that showed decreased healing because the studies were animal studies where the animals received a higher dose than patients would ever receive.

But new studies with people show the same results, causing some physicians to reconsider their use, or to at least limit the use of NSAIDS.

“Theoretically, it’s bad, but it doesn’t have practical application,” Dr. Trenhaile said. “It’s not that easy to draw the line in the sand because some people live on NSAIDS for all their aches and pains; they can’t function without them.”

It’s really a tradeoff between narcotics and NSAIDS.

“It’s a complicated answer for a straightforward question because patients often have other factors which need to be taken into account,” said Trenhaile.

Previous studies have also demonstrated an impact on fracture healing and spinal fusion.