Effectiveness of Selective Cyclooxygenase-2 Inhibitors for Postoperative Pain Management Using Multidimensional Pain Assessment: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Pooled result · Acute pain-related interference (Brief Pain Inventory)Result — go to the resultMD −1.1 95% CI −1.4 to −0.8Authors' conclusion
Perioperative selective COX-2 inhibitors likely provide a clinically meaningful reduction in acute pain - related interference with daily function and may improve chronic pain and quality of recovery.
Study context
- Population
- Adults undergoing surgery
- Participants
- 5,424 adults · 38 RCTs
- Comparison
- COX-2 inhibitors vs Placebo, opioids, or usual care
- Outcome
- Postoperative acute pain-related interference with daily living (validated multidimensional instrument, e.g. Brief Pain Inventory, 0 to 10 scale, MCID = 1.0)
- Follow-up
- Within 1 month after surgery
Pooled result
As reported in the abstract
Acute pain-related interference (Brief Pain Inventory)
MD
−1.1
95% CI −1.4 to −0.8
COX-2 inhibitors vs Placebo, opioids, or usual care
MD −1.1 (95% CI −1.4 to −0.8)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Chronic pain incidencen = 5 trials; low certainty | 0.44 (0.21–0.93) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | MD (95% CI) | |
|---|---|---|
| Chronic pain intensityn = 1 trial; very low certainty; no significant effect | −1.0 (−2.7 to 0.7) | |
| −4−202Difference (linear scale) |
Quality of recovery (QoR-9, 0 to 18 scale)
- Quality of recovery improved with the intervention: QoR-9 MD
- 0.84 (95% CI 0.33 to 1.35; n = 7 trials; low certainty)
Clinically important analgesic effect (modeled risk difference), acute pain
- Substantial benefit of COX-2 inhibitors for acute pain
Safety
Intraoperative blood loss
- Intraoperative blood loss lower with the intervention: MD
- −22 ml (95% CI −40 to −4 ml; n = 3 trials; low certainty)
Other adverse events (acute renal failure, GI bleeding, impaired bone healing, MI, stroke, death)
- No differences observed
Original publication
Effectiveness of Selective Cyclooxygenase-2 Inhibitors for Postoperative Pain Management Using Multidimensional Pain Assessment: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesthesiology. Published 29 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →