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Rao U et al. – More clarity is required with regards to the safety and efficacy of NSAIDs for postcraniotomy pain relief. What seems clear is that preoperative NSAIDs should be stopped prior to intracranial surgery, and that postoperative COX–2 inhibitors should not be used in patients with significant cardiac disease. These concerns contrast with the routine use of these agents in many centres, especially in Europe and Asia, for postoperative pain relief without any perceived or reported increase in complications.

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