SynthesisJournal of the American College of Surgeons2021
Systematic Review and Meta-Analysis of the Association Between Non-Steroidal Anti-Inflammatory Drugs and Operative Bleeding in the Perioperative Period.
Synthesis in Journal of the American College of Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.
- Intravenous ibuprofen in postoperative pain and fever management in adults: A systematic review and meta-analysis of randomized controlled trials.Pharmacology research & perspectives · 2023Pooled it
- Enhanced Recovery and Postoperative Analgesia After Laparoscopic Myomectomy: A Randomized Controlled Trial Comparing Total Intravenous Anesthesia, Transversus Abdominis Plane Block with Rectus Sheath Block, and Quadratus Lumborum Block.Drug design, development and therapy · 2026Trial
- Impact of intraoperative ketorolac on postoperative pain in children undergoing adenotonsillectomy: a double blind, placebo-control trial.Journal of anesthesia · 2025Trial
- Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial.Journal of pain research · 2023Trial
- Expert consensus on the application of nonsteroidal anti-inflammatory drugs for perioperative analgesia.Journal of anesthesia and translational medicine · 2026Article
- Association Between Postoperative NSAID Use and Bleeding Following Transoral Robotic Surgery.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- An update on the role of multimodal analgesia in perioperative pain management.Korean journal of anesthesiology · 2026Review
- Clinical Benefits of the Introduction of the ERAS Protocol in Thyroid Surgery: A Propensity Score Matching Analysis.Journal of clinical medicine · 2026Article
- Machine learning in bleeding risk assessment for low-molecular-weight heparin or fondaparinux: a predictive model study.Scientific reports · 2026Observational
- Article
- Psychological Resilience in Surgery: Psychobiological Pathways, Clinical Impact, and Perioperative Modulation-A Narrative Review.Journal of personalized medicine · 2026Review
- Routine Ketorolac Use for Postoperative Pain Does Not Increase Bleeding Risk After Hysterectomy.Journal of clinical medicine · 2026Article
- Impact of NSAIDs on post-operative bleeding in minor dental and oral surgery: A clinical study.Bioinformation · 2026Article
- The Impact of Socioeconomic Factors and Racial Disparities on Complications in Breast Conservation Surgery: A Single-Institution Retrospective Cohort Study.The breast journal · 2026Article
- Post-Thyroidectomy Opioid Prescription and Risk of Persistent Opioid Use: A Propensity Matched Cohort Study.Head & neck · 2025Article
- Balancing benefit and risk: clinical considerations in the use of acetaminophen, non-steroidal anti-inflammatory drugs, and dexamethasone for perioperative multimodal analgesia.The Korean journal of pain · 2025Review
- Ibuprofen is Not Associated With an Elevated Bleeding Risk or Transfusion Requirement in Skin Grafting for Patients With Burn Injuries.Journal of burn care & research : official publication of the American Burn Association · 2025Article
- Choosing a nonsteroidal anti-inflammatory drug for pain.Australian prescriber · 2025Review
- Postoperative pain management for caesarean section in Denmark: A survey of current clinical practice.Acta anaesthesiologica Scandinavica · 2025Article
- Risk factors and nursing strategies for postoperative pain management in patients with lumbar spinal stenosis undergoing transforaminal lumbar interbody fusion: a retrospective study.Frontiers in neurology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIt is increasingly recognized that non-opioid analgesia is an important analgesia in the perioperative period. Specifically, NSAIDs (nonsteroidal anti-inflammatory drugs) have been touted as an adjunct, or even replacement, for opioids. However, uptake of NSAIDs has been slow due to concern for side effects, including bleeding. We sought to understand the risk of bleeding caused by NSAIDs in the perioperative period. STUDY
designA physician-librarian team performed a search of electronic databases (MEDLINE, EMBASE), using search terms covering the targeted intervention (use of NSAIDs) and outcomes of interest (surgical complications, bleeding), limited to English language articles of any date. We performed a systematic review and meta-analysis of the data.
resultsA total of 2,521 articles were screened, and 229 were selected on the basis of title and abstract for detailed assessment. Including reference searching, 74 manuscripts met inclusion criteria spanning years 1987-2019. These studies included 151,031 patients. Studies included 12 types of NSAIDs, the most common being ketorolac, diclofenac, and ibuprofen, over a wide-range of procedures, from otorhinolaryngology (ENT), breast, abdomen, plastics, and more. More than half were randomized control trials. The meta-analyses for hematoma, return to the operating room for bleeding, and blood transfusions showed no difference in risk in any of 3 categories studied between the NSAID vs non-NSAID groups (p = 0.49, p = 0.79, and p = 0.49, respectively). Quality scoring found a wide range of quality, with scores ranging from lowest quality of 12 to highest quality of 25, out of a total of 27 (average = 16).
conclusionsNSAIDs are unlikely to be the cause of postoperative bleeding complications. This literature covers a large number of patients and remains consistent across types of NSAIDs and operations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.