Safety and Analgesic Outcomes of Nonsteroidal Anti-Inflammatory Drug-Containing Regimens After Transoral Robotic Surgery: A Systematic Review and Meta-Analysis.
Rahul D Patel, Connor J Dorais, Tristen Hofmann et al.
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In 30 seconds
This systematic review and meta-analysis assessed postoperative hemorrhage and analgesic outcomes with NSAID-containing regimens after transoral robotic surgery (TORS). Eight studies involving 2,519 patients contributed to the primary quantitative synthesis. Hemorrhage incidence in NSAID cohorts was 8.31% (95% CI: 4.91%-12.39%); NSAIDs were not associated with a statistically significant increase in hemorrhage risk (RR 1.56, p = 0.1768). The analysis also found lower pain scores within 72 hours, less inpatient opioid administration, and fewer discharge opioid prescriptions with NSAID-containing regimens.
Key findings
- Postoperative hemorrhage incidence in NSAID cohorts was 8.31% (95% CI: 4.91%-12.39%).
- NSAIDs did not significantly increase postoperative hemorrhage risk (RR 1.56, p = 0.1768).
- NSAID-containing regimens reduced 72-h pain scores (SMD -0.88) and inpatient opioid administration (SMD -1.06).
- NSAID use was associated with fewer opioid prescriptions at discharge.
Why it matters
Pain control and opioid exposure are important postoperative considerations after TORS, while hemorrhage remains a concern when using NSAIDs. This synthesis brings together evidence on both outcomes, suggesting that NSAID-containing regimens may offer analgesic and opioid-sparing benefits without a statistically significant increase in hemorrhage risk.
What to keep in mind
The quantitative synthesis included eight studies, and the abstract does not specify their designs or report the magnitude of the reduction in discharge opioid prescribing.