Celecoxib (Celebrex) is an oral, non-steroidal anti-inflammatory drug (NSAID). This class of medications typically inhibits two major isozymes: COX-1 (responsible for platelet aggregation, kidney perfusion, and gastrointestinal mucosa protection) and COX-2 (produced as a result of tissue damage to mitigate the inflammatory response). By selectively inhibiting COX-2, celecoxib tries to…
Ketorolac (Toradol) is a nonsteroidal anti-inflammatory drug (NSAID) I use as an analgesic adjunct in the OR and ICU. In some anesthesia texts, a single dose of IV ketorolac is said to confer analgesia equivalent to 10 mg of IV morphine (without narcotic-related side effects)! There’s some evidence from the…
Intravenous (IV) acetaminophen (Ofirmev) is a prime example of how multimodal analgesia can be augmented in the perioperative and ICU settings; however, just as with all things, cost drives availability. Literature has emerged trying to show the cost-effectiveness of IV acetaminophen compared to its oral counterpart, but some of these…