Why are there so many different opinions of the use of Celebrex before and after surgery?

Question

Why are there so many different opinions of the use of Celebrex before and after surgery? It can't be a gray issue, either it causes bleeding or it doesn't. Why can't all dr's agree on the use of it? All dr's agree on no ibuprofen. Are the one's that think it causes bleeding just not informed? I have an awful back and am having a tummy tuck in Dec. Celebrex really helps my back, but my dr says no to it 2 weeks before and after. It was part of my sister's protocol in recovery from a TT!

Larry S. Nichter, MD, MS, FACS · Answer

The reason for the gray areas answers is the literature indicates that there may be a risk of increase brusing/bleeding however it seems clear that the risk if FAR LOWER than aspirin, ibuprofen or naprosin. I use Celebrex for all of my plastic surgical procedures (unless they have a sulfa allergy) and have found no problems with increased bruising or bleeding.

Vincent N. Zubowicz, MD · Answer

All pain medications have some undesirable side effects. Generating a difference of opinion is how unwanted though side effects are to a prescribing surgeon.

Curtis Wong, MD · Answer

are like mouths and everyone has one.  However, Celebrex does not increase risks for bleeding (stomach ulcers yes) and I use it routinely in all of my procedures in hopes of minimizing the need for narcotics immediately after surgery.  Does it work?  I don't have any proof.  Is it harmful?  Not in my experience.  Surgeons that don't use it are just being ultraconservative and there is nothing wrong with that.  But I know Celebrex can be used and it has not increased my complication rate for bleeding.

Norman G. Morrison, MD, FACS (retired) · Answer

Celebrex is a
nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen.  Although Celebrex is found to have no
platelet interaction, and would not put a patient at risk for bleeding,
surgeons would still advise to discontinue all kinds of NSAIDs before surgery
to be more on the safe side.  Celebrex
may be used for pain after the surgery, but you are still at risk for its other
side effects such as stomach ulcers and bleeding.

Robert T. Buchanan, MD (retired) · Answer

Almost every surgeon I know understands that Celebrex increases leading during and immediately after surgery. NSAID's like Celebrex should be stopped for at least 2 weeks before surgery and almost everyone accepts this. It is generally the amount of time after surgery that it should not be used that is not universally agreed upon. Some also suggest that you should abstain for 2 weeks as your doctor. Others, like myself, believe that you only need to be off it until all the open vessels have totally closed. This only takes several days. However, if there are drains or other complications, then the period of abstinence needs to be longer.

Michael S. Hopkins, MD (retired) · Answer

All non-steroidal anti-inflammatory medicines can increase your risk of bleeding, as well as other possible side effects.  Unfortunately, human beings are not machines, so it is impossible to tell how much risk exists for any given individual. Physicians are always trying to balance risk versus benefit to each individual patient.  There is almost never a black and white answer.I would recommend you discuss you concern again with your surgeon. You may be able to figure out an alternate plan.  Best of luck.

Why are there so many different opinions of the use of Celebrex before and after surgery?

Answers (6)

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