A key component of modern analgesics is the use of multimodal opioid sparing analgesia (MOSA). In the past, our analgesic regime after autologous breast reconstruction (ABR) included either NSAID or a selective cyclooxygenase-2 inhibitor (COX-2). COX-2 inhibitors could be superior to NSAID due to the well-known side effects from NSAID (bleeding/gastrointestinal ulcers). However, COX-2 inhibitors have been suggested to increase flap failure rates. We report our experience with using COX-2 inhibitors as part of our postoperative MOSA after ABR using free flaps.
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