{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:27:00Z","timestamp":1786976820473,"version":"build-2736575974"},"reference-count":59,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T00:00:00Z","timestamp":1523491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Misuse and diversion of prescription opioids have been critical in facilitating the opioid epidemic. Our objective was to perform a systematic evidence\u2010based review delineating perioperative regimens (including opioid alternatives) evaluated for endoscopic sinus surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, Cochrane Library, and EmBase databases were evaluated for studies detailing analgesics employed after endoscopic sinus surgery. Studies were assessed for level of evidence. Bias risk was evaluated using the Cochrane Bias tool and GRADE criteria. Medication, administration, adverse effects, pain scores, and rescue analgesic consumption were evaluated. A summary of evidence detailing benefits, harm, and cost was prepared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two studies encompassing 1812 patients were included. The GRADE criteria determined the overall evidence to be of moderate quality. Perioperative acetaminophen had few adverse events and reduced immediate need for opioid rescue after sinus surgery; studies evaluating acetaminophen demonstrate a preponderance of benefit over harm. Nonsteroidal anti\u2010inflammatory drugs (NSAIDs) also reduce postoperative opioid consumption, although a small portion of patients undergoing sinus surgery harbor the potential for NSAID intolerance. The aggregate level of evidence for studies evaluating NSAIDs was grade A, whereas the aggregate grade of evidence for several other agents was grade B.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is evidence supporting the use of NSAIDs and gabapentin for the control of pain after endoscopic sinus surgery. Acetaminophen, \u03b1\u2010agonists, and local anesthetics are also viable options for postoperative analgesia. Familiarity with these data is essential to facilitate the use of opioid alternatives. Further large\u2010scale, multi\u2010institutional, randomized trials are needed to provide conclusive recommendations for these perioperative analgesics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.22107","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T08:10:47Z","timestamp":1523520647000},"page":"837-849","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence\u2010based review"],"prefix":"10.1002","volume":"8","author":[{"given":"Peter F.","family":"Svider","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Wayne State University School of Medicine  Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Wayne State University School of Medicine  Detroit MI"},{"name":"Department of Otolaryngology William Beaumont Hospital  Royal Oak MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Yuhan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Wayne State University School of Medicine  Detroit MI"},{"name":"Department of Otolaryngology William Beaumont Hospital  Royal Oak MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Zuliani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Wayne State University School of Medicine  Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-7818","authenticated-orcid":false,"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark NJ"},{"name":"Department of Ophthalmology and Visual Science Rutgers New Jersey Medical School  Newark NJ"},{"name":"Department of Neurological Surgery Rutgers New Jersey Medical School  Newark NJ"},{"name":"Center for Skull Base and Pituitary Surgery Neurological Institute of New Jersey Rutgers New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Folbe","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology William Beaumont Hospital  Royal Oak MI"},{"name":"Barbara Ann Karmanos Cancer Institute  Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,12]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"59","article-title":"Impact of endoscopic sinus surgery on the quality of life of patients with nasal polyposis","volume":"10","author":"Saedi B","year":"2014","journal-title":"B\u2010ENT"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin16.126"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.07.014"},{"key":"e_1_2_6_5_1","unstructured":"US Centers for Disease Control and Prevention.Opioid overdose.https:\/\/www.cdc.gov\/drugoverdose\/index.html\/. 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