Selective COX-2 inhibitors and the surgical patient.

The identification of COX-2 less than a decade ago has been followed by an unprecedented period of discovery and drug development (Golden & Abramson, 1999). Clinical studies thus far have established that the selective COX-2 inhibitors, celecoxib (Celebrex) and rofecoxib (Vioxx) are effective in the treatment of OA and RA, as are conventional NSAIDs. However, they do not cause the same adverse effects on the GI mucosa nor do they increase bleeding time as do conventional NSAIDs. Therefore, their use is not contraindicated in pre or postsurgical patients. Further investigation is underway to fully elucidate the role of COX-2 and to determine any additional benefits of selective COX-2 inhibition.