Assessing the Risk of Postoperative Hemorrhage With NSAID Use After Transoral Robotic Surgery

Area of Science:

• Otolaryngology
• Surgical Oncology
• Pharmacology

Background:

• Postoperative hemorrhage (POH) risk with NSAID use after trans-oral robotic surgery (TORS) oropharyngectomy is not well-documented.
• Limited data exists on the safety of NSAIDs for pain management in TORS patients.

Purpose of the Study:

• To investigate the association between perioperative NSAID administration and postoperative hemorrhage risk.
• To evaluate the safety of NSAIDs in patients undergoing TORS oropharyngectomy.

Main Methods:

• Retrospective propensity-matched cohort study using the TriNetX database.
• Patients were assigned cohorts based on NSAID administration within 7 days of TORS oropharyngectomy.
• 1761 patients were analyzed, with 621 in each propensity-matched cohort.

Main Results:

• Overall hemorrhage rate was 5.5%.
• No significant difference in primary POH (1.5% vs. 1.2%), secondary POH (5.2% vs. 4.2%), 30-day ER presentation (11.0% vs. 10.6%), or 30-day mortality (<1.5% vs. <0.9%) between NSAID and non-NSAID groups.
• Only 37.5% of patients received postoperative NSAIDs.

Conclusions:

• NSAID use after TORS oropharyngectomy is not associated with increased POH, ER return, or mortality.
• Current utilization of NSAIDs for post-TORS pain management appears low.
• Further research may support increased NSAID use for pain control in TORS patients.