{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:58:11Z","timestamp":1791878291823,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"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":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs) have emerged as an alternative to opioids for optimal postoperative pain management. However, the adoption of NSAIDs in sinonasal surgery has been impeded by a theoretical concern for postoperative bleeding. Our objective is to systematically review the efficacy and safety of NSAIDs for patients undergoing sinonasal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and the WHO International Clinical Trials Registry Platform were searched from inception to January 27, 2022. Randomized controlled trials (RCTs) and comparative observational studies in any language were considered. Screening, data extraction, and risk of bias assessment were performed in duplicate. Our outcomes were postoperative pain scores, requirement for rescue analgesia, and postoperative adverse events (epistaxis, nausea\/vomiting).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 4661 records, 15 RCTs (enrolling 1210 patients) and two observational studies were included. Following endoscopic sinus surgery, there was no difference in pain scores between NSAIDs and non\u2010NSAIDs groups (standardized mean differences [SMD] 0.44 units better, 95% CI \u20130.18 to 1.05). Following septorhinoplasty, NSAIDs decreased pain scores compared to non\u2010NSAID regimens (SMD 1.14 units better, 95% CI 0.61 to 1.67 units better). Overall, NSAIDs reduced the need for rescue medication with a relative risk (RR) of 0.45 (95% CI 0.24 to 0.84). In addition, NSAIDs decreased the risk of nausea with an RR of 0.62 (95% CI 0.42 to 0.91) and did not increase the risk of epistaxis (RR 0.72, 95% CI 0.23\u20102.22).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients undergoing sinonasal surgery, NSAIDs are beneficial in postoperative pain management and avoidance of postoperative nausea without increasing the risk of postoperative epistaxis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23140","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T11:27:00Z","timestamp":1676028420000},"page":"1738-1757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The benefits and risks of non\u2010steroidal anti\u2010inflammatory drugs for postoperative analgesia in sinonasal surgery: a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4057-2858","authenticated-orcid":false,"given":"Daniel J.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3054-3474","authenticated-orcid":false,"given":"Elysia","family":"Grose","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head &amp; Neck Surgery St. Michael's Hospital, Unity Health Toronto University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6126-3897","authenticated-orcid":false,"given":"Connor T. A.","family":"Brenna","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Pain Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Philteos","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head &amp; Neck Surgery St. Michael's Hospital, Unity Health Toronto University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lightfoot","sequence":"additional","affiliation":[{"name":"St. Michael's Hospital Health Sciences Library, Unity Health Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshinisuthan","family":"Kirubalingam","sequence":"additional","affiliation":[{"name":"School of Medicine Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head &amp; Neck Surgery St. Michael's Hospital, Unity Health Toronto University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head &amp; Neck Surgery St. Michael's Hospital, Unity Health Toronto University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001904"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14791"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2008\/11\/S105"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181cf9281"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481408000314"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002132"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200506000-00027"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew391"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319866824"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.04.032"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818757959"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00672"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.12.023"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2019.05.016"},{"key":"e_1_2_8_16_1","unstructured":"National Survey on Drug Use and Health (U.S.).Resultsfrom the \u2026National Survey on Drug Use and Health. 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