- Patients undergoing functional endoscopic sinus surgery (FESS) who received ibuprofen and paracetamol as first-line treatment for pain, with opioid as rescue treatment, reported less pain and used fewer opioid pills than patients who received opioids for pain management with NSAIDs.
Why this matters
- Clinicians had been hesitant to rely on NSAIDs for pain relief after otolaryngologic surgeries because of concerns about bleeding complications, but NSAID-first users in this study reported no bleeding issues.
- Prospective cohort study on patients undergoing FESS/other endoscopic nasal surgeries (74 without NSAIDs; 101 with NSAIDs).
- Funding: None disclosed.
- The overall mean pain visual analogue scale (VAS) scores were 3.12 in the non-NSAID group and 2.33 in the NSAID group (P=.006).
- Pain VAS scores decreased significantly over the week (P<.0001>
- The pain VAS score was highest on day 1 postoperation (day 1 vs day 2, P=.015; day 1 vs days 2-7, P<.0001>
- 147 patients who completed the pain diary had mean pain VAS scores of:
- 2.44 (overall); and
- 3.05 (average from days 1-7).
- The average number of total opioid pills without NSAIDs vs with NSAIDs was 6.94 vs 3.77 (P=.018).
- Pain levels could not be compared between a full FESS and a single sinus surgery.
Coauthored with Chitra Ravi, MPharm