The Journal of laryngology and otology · 2026
The safety of selective COX-2 inhibitors in tonsillectomy patients: a systematic review.
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Dunmall Sophie, Lizarondo Lucylynn, Jia Romy, Ooi Eng Hooi
Аннотация
OBJECTIVES: This study aimed to determine the safety of selective cyclooxygenase 2 inhibitors in tonsillectomy patients.
METHODS: A systematic review of the literature was undertaken in August 2024 (updated March 2025) using Joanna Briggs Institute systematic review and critical appraisal methodology. Study outcomes were bleeding incidence, analgesic efficacy and adverse effects. Eligible comparators were non-cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs or placebo.
RESULTS: Fifteen studies were included for meta-analysis, 14 of which were randomised control trials. The studies were overall of good quality. There was no increased risk of bleeding with selective cyclooxygenase 2 inhibitors (odds ratio = 1.27; 95 per cent confidence interval: 0.51 to 3.16; p = 0.61). They were more effective than placebo in providing analgesia (odds ratio = -1.22; 95 per cent confidence interval, -2.12 to -0.33; Z = 2.67; p = 0.007; I2 = 84 per cent).
CONCLUSION: Selective cyclooxygenase 2 inhibitors do not cause an increase in bleeding risk for tonsillectomy patients. There is insufficient evidence to compare their safety and efficacy to non-selective non-steroidal anti-inflammatory drugs such as ibuprofen.
METHODS: A systematic review of the literature was undertaken in August 2024 (updated March 2025) using Joanna Briggs Institute systematic review and critical appraisal methodology. Study outcomes were bleeding incidence, analgesic efficacy and adverse effects. Eligible comparators were non-cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs or placebo.
RESULTS: Fifteen studies were included for meta-analysis, 14 of which were randomised control trials. The studies were overall of good quality. There was no increased risk of bleeding with selective cyclooxygenase 2 inhibitors (odds ratio = 1.27; 95 per cent confidence interval: 0.51 to 3.16; p = 0.61). They were more effective than placebo in providing analgesia (odds ratio = -1.22; 95 per cent confidence interval, -2.12 to -0.33; Z = 2.67; p = 0.007; I2 = 84 per cent).
CONCLUSION: Selective cyclooxygenase 2 inhibitors do not cause an increase in bleeding risk for tonsillectomy patients. There is insufficient evidence to compare their safety and efficacy to non-selective non-steroidal anti-inflammatory drugs such as ibuprofen.