Assessing the efficacy of celecoxib after tonsillectomy and/or adenoidectomy: A systematic review and meta-analysis of randomised control trials

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-06-14 DOI:10.1111/coa.14177

Umm E Salma Shabbar Banatwala, Abdul Rehman Shah Syed, Noor Ul Ain, Aimen Zulfikar, Ilqa Ikram Akhund, Rija Lodhi, Rameesha Baig, Laiba Ghufran, Ayesha Rizwan, Meena Bai, Mahima Khatri, Satesh Kumar

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引用次数: 0

Abstract

Objectives

Tonsillectomy and adenoidectomy are common surgical procedures that cause persistent pain, bleeding, and functional limitations. We aimed to investigate the efficacy of celecoxib compared with a placebo for managing post-tonsillectomy or adenoidectomy pain and other adverse events.

Design

Systematic review and meta-analysis.

Methods

We conducted a systematic literature search in the PubMed, Cochrane, and Google Scholar databases from inception until July 2023. Dichotomous outcomes have been reported as risk ratios (RR) while continuous outcomes were reported using mean differences (MD). A funnel plot was drawn to investigate publication bias.

Results

From 1394 records identified, 6 randomised double-blind trials comprising 591 participants undergoing tonsillectomy and/or adenoidectomy were eligible for inclusion. A high dose (400 mg) of celecoxib was effective in decreasing the pain score for ‘worst pain’ after the procedure (MD: −10.98, [95% CI: −11.53, −10.42], p < .01, I² = 0%) while a low dose (200 mg) was not significantly effective (p = 0.31). For managing other outcomes such as vomiting (RR: 1.37 [95% CI: 0.69, 2.68], p = 0.37, I² = 67%), diarrhoea (RR: 1.41, [95% CI: 0.75, 2.64], p = .29, I² = 42%), dizziness/drowsiness (RR: 0.90, [95% CI: 0.71, 1.15], p = .48, I² = 0%), functional recovery time (p = .74), and headache (p = .91), there was no significant difference between the group on celecoxib and the placebo group regardless of dosage. Finally, there was no significant difference (RR: 1.02, [95% CI: 0.91, 1.15], p = .69, I² = 0%) in the effect of the intervention on minimum bleeding, moderate bleeding, and profuse bleeding.

Conclusion

This meta-analysis provides robust evidence pooled from high-quality trials and raises questions about the efficacy of celecoxib for tonsillectomy and/or adenoidectomy, challenging existing perceptions.

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评估扁桃体切除术和/或腺样体切除术后塞来昔布的疗效：随机对照试验的系统回顾和荟萃分析。

目的：扁桃体切除术和腺样体切除术是常见的外科手术，会导致持续疼痛、出血和功能受限。我们旨在研究塞来昔布与安慰剂相比在控制扁桃体切除术或腺样体切除术后疼痛及其他不良反应方面的疗效：系统回顾和荟萃分析：我们在 PubMed、Cochrane 和 Google Scholar 数据库中进行了系统性文献检索，检索时间从开始到 2023 年 7 月。二分结果用风险比（RR）报告，连续结果用平均差（MD）报告。绘制了漏斗图以调查发表偏倚：从已确定的 1394 份记录中，有 6 项随机双盲试验符合纳入条件，其中包括 591 名接受扁桃体切除术和/或腺样体切除术的患者。高剂量（400毫克）塞来昔布能有效降低术后 "最严重疼痛 "的疼痛评分（MD：-10.98，[95% CI：-11.53，-10.42]，P 2 = 0%），而低剂量（200毫克）则无明显效果（P = 0.31）。对于管理其他结果，如呕吐（RR：1.37 [95% CI：0.69，2.68]，p = 0.37，I2 = 67%）、腹泻（RR：1.41，[95% CI：0.75，2.64]，p = .29，I2 = 42%）、头晕/嗜睡（RR：0.90，[95% CI：0.71，1.15]，p = .48，I2 = 0%）、功能恢复时间（p = .74）和头痛（p = .91），服用塞来昔布组与安慰剂组无论剂量大小均无显著差异。最后，干预对最低出血量、中度出血量和大量出血量的影响无明显差异（RR：1.02，[95% CI：0.91，1.15]，p = .69，I2 = 0%）：这项荟萃分析提供了从高质量试验中汇集的可靠证据，并对塞来昔布用于扁桃体切除术和/或腺样体切除术的疗效提出了质疑，对现有观点提出了挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.