Acute Pain Syndrome: What Determines the Choice of Analgesic? The Role of Nimesulide in Multimodal Therapy | Ukrainian Medical Journal

Acute pain following trauma, surgical procedures, and dental interventions often has a pronounced inflammatory component, which provides a rationale for the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as part of multimodal analgesia. This article discusses the pathophysiological mechanisms of acute pain, the role of NSAIDs in pain management, and the place of nimesulide in current clinical practice. The results of the SAFE-2 study on the efficacy and short-term tolerability of nimesulide-containing therapy in various acute pain conditions are analyzed, along with data on the use of nimesulide for post-extraction dental pain. Particular attention is paid to the safety of short-term therapy, including the risk of hepatotoxicity, renal, gastrointestinal, and cardiovascular complications, drug interactions, and the management of surgical patients with concomitant risk factors. A practical algorithm for selecting analgesic therapy is proposed. Rational use of nimesulide requires an individualized assessment of the patient, evaluation of the benefit–risk balance, and use of the lowest effective dose for the shortest clinically necessary period.

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