title: Variation in postoperative non-steroidal anti-inflammatory analgesic use after colorectal surgery: a database analysis.
abstract: BACKGROUND
  Non-steroid anti-inflammatory drugs (NSAIDs) have been proposed as part of a multimodal postoperative analgesia in patients operated for colorectal cancer. However, whether these drugs are prescribed and taken by the patients have not been evaluated. The aim of this study was to quantify the postoperative use of NSAIDs in these patients.
  
  
  METHODS
  Data from patients operated for colorectal cancer between January 1, 2006 and December 31, 2009 were collected from the Danish Colorectal Cancer Group's (DCCG) prospective database. From the electronically registered medical records, data for the use of the two NSAIDs diclofenac and ibuprofen were recorded. The data from six colorectal departments in eastern Denmark were compared.
  
  
  RESULTS
  Of the 2,754 patients analyzed overall, 40.6% received NSAIDs as part of their analgesic treatment. The percentage of the patients receiving NSAIDs, receiving a pre-defined dosage as a minimum and receiving NSAIDs as p.r.n. medication, and the type of NSAID were significantly different both between department and within departments. The median dose of ibuprofen and diclofenac were 1200 mg (400-2,400 mg) and 100 mg (50-200 mg), respectively.
  
  
  CONCLUSIONS
  The large variation between and within the departments points to an inconsistency in the use of multimodal post-operative pain treatments. This may be a result of insufficient evidence on procedure specific pain treatments and possibly a lack of compliance to existing guidelines. High-quality large-scale studies are warranted to form the basis for guidelines for postoperative analgesic treatment.
authors.affiliation: Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark. hcpommergaard@gmail.com.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Pommergaard
authors.forename: Mads
authors.initials: M
authors.lastname: Klein
authors.forename: Jakob
authors.initials: J
authors.lastname: Burcharth
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
authors.forename: Jørgen B
authors.initials: JB
authors.lastname: Dahl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003107:Colorectal Surgery / Q000009:adverse effects* / Q000639:trends; D016208:Databases, Factual / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy* / Q000453:epidemiology; D011446:Prospective Studies; D013223:Statistics as Topic / Q000379:methods; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal