Author: Miao, T. et al.
Canadian Journal of Anesthesia. 2025.
This single-centre historical cohort study examined the safety of nonselective NSAID use following cardiac surgery in 431 adult patients. Within 7 days of NSAID exposure, 12% developed acute kidney injury (AKI), 1% experienced major adverse cardiovascular events (MACE), and 3% had major bleeding. Despite these risks, NSAID use was associated with improved pain control, reduced opioid requirements, and less supplemental oxygen need.
Machine learning analysis highlighted low preoperative estimated glomerular filtration rate (eGFR) as the strongest predictor of postoperative AKI. Other predictors included older age, prior stroke, anemia, and elevated preoperative platelet count, INR, and BUN. Notably, the incidence of AKI in this study was lower than in earlier reports, likely reflecting careful patient selection.
What you should know:
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NSAIDs provided effective pain relief and opioid-sparing benefits after cardiac surgery.
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AKI occurred in 12% of patients, but rates were lower than previously reported.
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Careful patient selection is critical; preoperative renal function is the strongest risk factor.
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NSAIDs may be used cautiously in multimodal analgesia if risk factors are considered.
Thank you to the Canadian Journal of Anesthesia for allowing me to use and summarize this article.