The risk with Toradol and other NSAID's in the post op period was usually related to kidney injury and potential bleeding complications. But NSAID's work by attenuating the body's natural inflammatory response to stress. And sometimes that inflammatory response is beneficial. As a surgeon I need that inflammatory response to occur, especially if I am sewing one end of bowel to another. Those inflammatory mediators bring the kinds of cells and proteins necessary for a strong anastomosis.
The JAMA paper is a large retrospective cohort study over over 13,000 patients who had undergone colorectal or bariatric surgery at over 40 hospitals in Washington state. The question the investigators asked was: how was the leak rate affected when NSAID's were started within 24 hours of surgery? The findings:
The overall 90-day rate of anastomotic leaks was 4.3% for all patients (151 patients [4.8%] in the NSAID group and 417 patients [4.2%] in the non-NSAID group; P = .16). After risk adjustment, NSAIDs were associated with a 24% increased risk for anastomotic leak (odds ratio, 1.24 [95% CI, 1.01-1.56]; P = .04). This association was isolated to nonelective colorectal surgery, for which the leak rate was 12.3% in the NSAID group and 8.3% in the non-NSAID group