Nouveautés concernant les anti-inflammatoires stéroïdiens et non stéroïdiens

Steroids and non-steroidal anti-inflammatory drugs are commonly used perioperatively to improve the control of postoperative pain and to decrease the incidence of nausea and vomiting. Steroids as inhibitors of phospholipase and non-steroidal anti-inflammatory drugs as inhibitors of cyclo-oxygenases reduce pain intensity and postoperative morphine demand in many surgical procedures. Non-steroidal anti-inflammatory drugs are reported to increase the risks of postoperative bleeding due to platelet aggregation inhibition, gastric ulceration, and renal failure. Bleeding risk is decreased when using selective COX-2 inhibitors. Both selective and non-selective non-steroidal anti-inflammatory drugs may increase the thrombotic risk. There is a controversy about the opportunity for steroids to increase the incidence of septic complications and postoperative bleeding. Steroids and non-steroidal anti-inflammatory drugs may be considered as part of multimodal analgesia but their administration requires an evaluation of the balance between benefits and risks.