The Efficacy of Oral Celecoxib Following Surgical Rhinoplasty

Abstract

Importance:

Exploring potential methods of controlling postoperative rhinoplasty pain with non-narcotic medications.

Objective:

To examine the effects of celecoxib in reducing pain and possible opioid consumption after rhinoplasty surgery.

Design, Setting, and Participants:

This is a prospective cohort study of 51 consecutive patients who had undergone rhinoplasty surgery between July 2018 and May 2019 by a single facial plastic surgeon. A questionnaire regarding pain medication usage and complications was given to each patient at his or her initial 1-week postoperative visit. Patients were separated into groups based on whether celecoxib had been used perioperatively or not.

Main Outcomes and Measures:

In addition to demographic information, the following outcome measures were recorded for each group: type(s) of pain medications used, total opioid consumption, refills required, surgical complications, and related analgesic adverse effects.

Results:

Of the 51 patients included, 17 patients were provided celcoxib. Mean oxycodone–acetaminophen tablets taken in the celecoxib cohort was 4.2 (CI = 2.4–6.1), whereas mean tablets taken among controls was 14.8 (CI = 11.1–18.4) (p = 0.0006). Mean oxycodone–acetaminophen dose taken in the celecoxib cohort was 17.6 mg (CI = 9.0–26.3), whereas the mean among controls was 73.8 mg (CI = 55.5–92.0) (p = 0.0001). Mean total oral morphine equivalents (OMEs) were also reduced with an average of 26.5 OME (CI = 13.5–39.4) in the celecoxib cohort and 110.7 OMEs (CI = 83.3–138.0) in the control group (p = 0.001). Postoperative nausea and vomiting were significantly reduced in the celecoxib cohort versus the control group (p = 0.02). Overall, with the addition of celecoxib, there was a 76.2% decrease in milligrams of opioid use and an 83.4% decrease in incidence of nausea/vomiting.

Conclusions and Relevance:

Oral celecoxib appears to be effective in decreasing opioid consumption and nausea/vomiting rates after rhinoplasty without increasing surgical complications.

Level of Evidence:

2