Pain medicine

Risks of Serious Adverse Events Associated With Non‐Steroidal Anti‐Inflammatory Drugs in Orthopaedic Surgery. A Systematic Review With Meta‐Analysis and Trial Sequential Analysis

Acta Anaesthesiol ScandPublished Systematic review and meta-analysis of randomised trials

Pooled result · Serious adverse eventsResult — go to the resultRelative risk 0.83 95% CI 0.61–1.14

Authors' conclusion

In adult patients undergoing orthopaedic surgery, we found no evidence of a difference between NSAID and placebo regarding risk of serious adverse events.

Study context

Population
Patients undergoing orthopaedic surgery
Participants
6,593 patients · 38 trials
Comparison
Perioperative NSAID vs placebo, usual care, or no intervention
Outcome
Incidence of serious adverse events
Methodological detailstrial sequential analysis, GRADE certainty assessment
  • Trial sequential analysis
  • GRADE certainty assessment

Pooled result

Serious adverse events

Relative risk

0.83

95% CI 0.61–1.14

P = 0.26

NSAID vs Placebo
RR 0.83 (95% CI 0.61–1.14); P = 0.26

As reported in the abstract

Further pooled results

OutcomeOR (95% CI)P value
Serious adverse events, incl. zero-event trials (post hoc beta-binomial regression sensitivity analysis)Post hoc0.89 (0.76–1.06)P = 0.19

Original publication

Risks of Serious Adverse Events Associated With Non‐Steroidal Anti‐Inflammatory Drugs in Orthopaedic Surgery. A Systematic Review With Meta‐Analysis and Trial Sequential Analysis. Acta Anaesthesiol Scand. Published 16 April 2026. doi:10.1111/aas.70237

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