Total joint arthroplasty is a rapid recovery procedure with patients optimized quickly in preparation for discharge. Two significant postoperative goals are effective pain management and prevention of postoperative venous thromboembolism (VTE). Low-risk patients receive aspirin 81 mg twice daily for VTE prophylaxis; this dosing regimen has been reduced over the past few years from 325 mg to 162 mg to 81 mg twice daily. Unless contraindications exist, all patients receive multimodal pain management that includes the use of celecoxib or meloxicam. Upon reduction of the aspirin dose to 81 mg twice daily, we rapidly identified 2 patients who developed a pulmonary embolus when celecoxib or meloxicam was administered concurrently with aspirin. The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin varies among the different NSAIDs. It is also highly dependent on numerous factors, including time of administration, dose of aspirin, and both pharmacodynamics and dose of the NSAID. Real-world outcomes of concomitant administration of NSAIDs with low-dose aspirin led to increased incidence of VTE, possibly due to competitive inhibition of aspirin at platelet receptor sites. This interaction was mitigated by altering the administration times of both agents.

全关节置换术是一种快速恢复程序，患者可以快速优化以准备出院。术后的两个重要目标是有效的疼痛管理和预防术后静脉血栓栓塞（VTE）。低危患者每天两次接受阿司匹林81 mg预防VTE；在过去的几年中，这种给药方案已从每天325毫克减少到162毫克，再减少到每天81毫克。除非有禁忌症，否则所有患者均应接受多模态疼痛管理，包括使用塞来昔布或美洛昔康。将阿司匹林的剂量减至每天两次81 mg后，我们迅速确定2例在将celecoxib或meloxicam与阿司匹林同时使用时出现肺栓塞的患者。非甾体抗炎药（NSAID）与小剂量阿司匹林之间的相互作用在不同的NSAID之间有所不同。它还高度依赖许多因素，包括给药时间，阿司匹林的剂量以及NSAID的药效学和剂量。NSAIDs与小剂量阿司匹林同时给药的现实结果导致VTE发生率增加，这可能是由于阿司匹林在血小板受体部位的竞争性抑制所致。通过更改两种药物的给药时间可以缓解这种相互作用。可能是由于阿司匹林在血小板受体部位的竞争性抑制。通过更改两种药物的给药时间可以缓解这种相互作用。可能是由于阿司匹林在血小板受体部位的竞争性抑制。通过更改两种药物的给药时间可以缓解这种相互作用。