• Kimberly B Tworek, Chen-Hsiang Ma, Dawn Opgenorth, Nadia Baig, Fernando G Zampieri, John Basmaji, Bram Rochwerg, Kimberley Lewis, Sebastian Kilcommons, Sangeeta Mehta, Kimia Honarmand, H Tom Stelfox, M Elizabeth Wilcox, Demetrios J Kutsogiannis, Kirsten M Fiest, Constantine J Karvellas, Wendy Sligl, Oleksa Rewa, Janek Senaratne, Sameer Sharif, Sean M Bagshaw, and Vincent I Lau.
• Alberta Health Services, Edmonton, AB, Canada. tworek@ualberta.ca.
• Can J Anaesth. 2024 Oct 1; 71 (10): 138813961388-1396.

PurposeOpioids remain the mainstay of analgesia for critically ill patients, but its exposure is associated with negative effects including persistent use after discharge. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be an effective alternative to opioids with fewer adverse effects. We aimed to describe beliefs and attitudes towards the use of NSAIDs in adult intensive care units (ICUs).MethodsOur survey of Canadian ICU physicians was conducted using a web-based platform and distributed through the Canadian Critical Care Society (CCCS) email distribution list. We used previously described survey development methodology including question generation and reduction, pretesting, and clinical sensibility and pilot testing.ResultsWe received 115 completed surveys from 321 CCCS members (36%). Nonsteroidal anti-inflammatory drugs use was most described as "rarely" (59 respondents, 51%) with the primary concern being adverse events (acute kidney injury [108 respondents, 94%] and gastrointestinal bleeding [92 respondents, 80%]). The primary preferred analgesic was acetaminophen (75 respondents, 65%) followed by opioids (40 respondents, 35%). Most respondents (91 respondents, 80%) would be willing to participate in a randomized controlled trial examining NSAID use in critical care.ConclusionsIn our survey, Canadian critical care physicians did not mention commonly using NSAIDs primarily because of concerns about adverse events. Nevertheless, respondents were interested in further studying ketorolac, a commonly used NSAID outside of the ICU, in critically ill patients.© 2024. Canadian Anesthesiologists' Society.

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