title: Continuous Infusion Nonsteroidal Anti-Inflammatory Drugs for Perioperative Pain Management.
abstract: OBJECTIVE
  To review the use of continuous infusion (CI) nonsteroidal anti-inflammatory drugs (NSAIDs) as an alternative modality for pain control in surgical patient populations.
  
  
  METHODS
  A PubMed and MEDLINE search was conducted from 1964 through February 2016 using the following search terms alone or in combinations: continuous, infusion, nonsteroidal anti-inflammatory drug, diclofenac, ibuprofen, indomethacin, ketoprofen, ketorolac, and surgery. All English-language, prospective and retrospective, adult and pediatric studies evaluating intravenous or intramuscular CI NSAIDs for surgical pain were evaluated for inclusion in this review.
  
  
  RESULTS
  Twenty four prospective and retrospective publications evaluating CI NSAIDs were identified: 12 in abdominal surgery, 7 in orthopedic surgery, and 5 in pediatric surgery. Specific CI NSAIDs utilized included diclofenac, indomethacin, ketoprofen, and ketorolac. Most studies compared the CI NSAID to placebo or an alternative analgesic and evaluated pain control, supplemental opioid use, and related adverse effects. In these surgical populations, CI NSAIDs decreased opioid consumption, alongside provision of adequate pain control. While long-term adverse effects were rarely collected, a decrease in nausea and sedation was often seen with the CI NSAID groups.
  
  
  CONCLUSIONS
  In the abdominal, orthopedic, and pediatric surgical populations, CI NSAIDs represent a feasible alternative modality for perioperative pain control.
authors: 1 Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Fort Worth, TX, USA.
authors: Meredith L
authors: ML
authors: Howard
authors: 2 Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN, USA.|3 Department of Pharmacy, Eskenazi Health, Indianapolis, IN, USA.
authors: Alex N
authors: AN
authors: Isaacs
authors: 4 School of Pharmacy, Wingate University, Wingate, NC, USA.|5 Department of Pharmacy, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
authors: Sarah A
authors: SA
authors: Nisly
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D019990:Perioperative Care / Q000379:methods*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: continuous infusion; nonsteroidal anti-inflammatory drug; pain; perioperative; safety