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NSAIDs, when used in sinonasal surgery, effectively reduce postoperative pain and the occurrence of postoperative nausea, while posing no increased risk of postoperative epistaxis.
In individuals who underwent sinonasal surgery, the utilization of non-steroidal anti-inflammatory drugs (NSAIDs) proved to be beneficial in managing postoperative pain and preventing postoperative nausea, all without escalating the risk of postoperative epistaxis, as elucidated from a
systematic review and meta-analysis published in "International Forum of Allergy & Rhinology".
Daniel J Lee et al. sought to evaluate the safety and effectiveness of NSAIDs in patients who had undergone sinonasal surgery.
Databases such as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and the World Health Organization (WHO) International Clinical Trials Registry Platform were explored. Comparative observational studies and randomized controlled trials (RCTs) in any language were considered. The examination of the risk of bias, data extraction, and screening were carried out in duplicate.
The instances of postoperative adverse events, such as epistaxis and vomiting/nausea, the need for rescue analgesia, and postoperative pain scores were the major endpoints ascertained. From a pool of 4661 records, the study incorporated 15 RCTs involving 1210 subjects, along with 2 observational studies. In the case of endoscopic sinus surgery, no notable disparity in pain scores was observed between the groups using NSAIDs and those not using them, as indicated by a standardized mean difference (SMD) of 0.44 units in favor of NSAIDs.
However, after septorhinoplasty, NSAIDs demonstrated a significant reduction in pain scores in comparison with the non-NSAID regimens, with an SMD of 1.14 units in favor of NSAIDs. As found, NSAIDs exhibited a capacity to decrease the necessity for rescue medication (relative risk [RR]: 0.45). Furthermore, the use of NSAIDs was associated with a diminished risk of nausea (RR: 0.62), and it did not result in an increased risk of epistaxis (RR: 0.72). Hence, NSAIDs play a valuable role in controlling postoperative pain and preventing postoperative nausea in people who undergo sinonasal surgery.
International Forum of Allergy & Rhinology
The benefits and risks of non-steroidal anti-inflammatory drugs for postoperative analgesia in sinonasal surgery: a systematic review and meta-analysis
Daniel J Lee et al.
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