{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:29:26Z","timestamp":1775557766756,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The opioid epidemic has highlighted the value of multimodal analgesia, with NSAIDs showing promise in reducing narcotic use and managing postoperative pain. While concerns about NSAIDs increasing bleeding risk remain debated, particularly in facial surgeries like rhinoplasty, this study pools data to systematically evaluate the safety and efficacy of NSAIDs for this procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Cochrane, and Web of Science.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Databases were queried for English\u2010language studies containing original data on perioperative NSAID administration in rhinoplasty patients between 1990 and 2024. Primary outcomes reviewed were postoperative pain, nausea and vomiting (PONV), bleeding, and narcotic use. Studies without outcome measures were excluded. Two investigators independently reviewed manuscripts and performed quality assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 660 abstracts identified, 8 studies met eligibility: 7 randomized controlled trials and 1 cohort study. Six underwent meta\u2010analysis, including 470 patients (260 receiving NSAIDs, 210 receiving placebo). Rhinoplasty patients receiving perioperative NSAIDs demonstrated significantly lower postoperative pain scores (standard mean difference [SMD]\u2009=\u20091.20 [95% CI: 2.01\u20130.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004]) and total opioid consumption (SMD\u2009=\u20091.43 [95% CI: 2.23\u20130.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005]). PONV was 27% less likely in the NSAID group (odds ratio [OR]\u2009=\u20090.27 [95% CI: 0.17\u20130.44,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00001]). No significant difference in bleeding existed between groups (OR\u2009=\u20091.28 [95% CI: 0.34\u20134.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.71]). Quality assessment indicated a low risk of bias for all but two studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis indicates that NSAIDs are a safe, effective first\u2010line analgesic for rhinoplasty, without increasing postoperative bleeding risk. NSAID use significantly reduces postoperative narcotic usage and PONV. Further research is needed to examine alternative agents and dosing regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32413","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T12:25:46Z","timestamp":1752063946000},"page":"4529-4541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Safety and Efficacy of Perioperative\n                    <scp>NSAIDs<\/scp>\n                    in Rhinoplasty\u2014A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5600-004X","authenticated-orcid":false,"given":"Emmi","family":"Deckard","sequence":"first","affiliation":[{"name":"University of California Riverside School of Medicine  Riverside California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ketan","family":"Jain\u2010Poster","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente Oakland Medical Center  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Rivero","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente Oakland Medical Center  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"\u201c2020 Plastic Surgery Statistics Report\u201d(2020)."},{"key":"e_1_2_8_3_1","unstructured":"\u201c2023 ASPS Procedural Statistics Release\u201d(2023)."},{"key":"e_1_2_8_4_1","volume-title":"StatPearls [Internet]","author":"Horn R.","year":"2024"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2022.04.002"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20102111\u20109203"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000003305"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2019.29014.new"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599821996297"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22478"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820947013"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2017.05.008"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020042"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23140"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001898"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7103a1"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3945"},{"key":"e_1_2_8_20_1","first-page":"1828","article-title":"Comparison of the Effects of Preoperative and Intraoperative Intravenous Application of Dexketoprofen on Postoperative Analgesia in Septorhinoplasty Patients: Randomised Double Blind Clinical Trial","volume":"16","author":"Ozer A. 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