Читать книгу Fractures in the Horse - Группа авторов - Страница 156

Non‐steroidal anti‐inflammatory drugs (NSAIDs) are a mainstay of reducing pain in horses. Their effect on bone healing is controversial [44], and use in horses undergoing fracture repair is a source of debate [45]. In people and experimental animals, it has been well documented that the early inflammatory phase is key to bone healing (Section Cellular and Humeral Influences on Bone Healing). In addition to experimental animal evidence, there is some suggestion in humans that fracture healing can be delayed, and in most clinical situations, NSAIDs are avoided following fracture repair [46]. In one study, phenylbutazone decreased mineral apposition rate in cortical bone, but there was no difference in the percentage of mineralized tissue [45]. A recent study in dogs showed no significant difference in tibial osteotomy healing with short‐term administration of carprofen (two weeks); however, there was significant delay in healing with long‐term administration (eight weeks), leading to the conclusion that NSAIDs should only be used in the perioperative period [47]. The evidence is therefore inconclusive. The author is unaware of any clinical evidence to suggest that NSAIDs used in the perioperative period have a negative impact on fracture repair in horses. The potential negative effects on bone healing must also be weighed against the possible positive effects on healing, especially in the case of severe soft tissue trauma and ongoing inflammation [15], and on the overall status of the patient. Phenylbutazone, flunixin meglumine and firocoxib can all be considered.