Association Between Perioperative Celecoxib, Acetaminophen, and Opioid Consumption After Palate Surgery for Obstructive Sleep Apnea.

Abstract

Objective: To examine the effect of perioperative celecoxib and acetaminophen administration on opioid consumption in the first 24 hours after palate surgery for obstructive sleep apnea (OSA).

Study design: Retrospective cohort study.

Setting: Tertiary academic center.

Methods: Adults with OSA undergoing soft palate surgery and admitted to the hospital postoperatively between July 2013 and June 2023 were included. Study participants were also included if they underwent concurrent nasal surgery but excluded if they underwent any pharyngeal surgery other than tonsillectomy or were taking opioids prior to surgery. Opioids administered after surgery were converted to morphine milligram equivalents (MME). Multiple linear regression was used to examine the association between total MME consumed in the first 24 hours postoperatively and celecoxib and acetaminophen usage.

Results: A total of 210 study participants (15.7% female) were included with a mean age of 48.8 ± 37.5 years. The mean MME consumed in the first 24 hours after palate surgery was 80.2 ± 63.9. One hundred and twenty-six (60%) study participants received perioperative celecoxib, while 195 (93%) received perioperative acetaminophen. Celecoxib use was associated with lesser MME (-2.7 ± 1.1 MME per 100 mg; P = .018) consumed postoperatively, while acetaminophen was not (-0.3 ± 0.3 MME per 100 mg; P = .43). Female gender, Asian race, and African American race were also associated with lesser MME consumed postoperatively, while autoimmune/immunosuppressive conditions and tonsillectomy were associated with greater MME consumption.

Conclusion: Perioperative celecoxib was associated with reduced MME consumption in the first 24 hours after palate surgery. No association was found between acetaminophen and postoperative opioid use.