Nonsteroidal anti-inflammatory drugs for postoperative pain control after lumbar spine surgery: A meta-analysis of randomized controlled trials

Study objective: Nonsteroidal anti-inflammatory drugs (NSAIDs) play a role in pain relief, especially in postoperative pain caused by inflammation. They have demonstrated significant opioid dose-sparing effects, which help in reducing postoperative effects and opioid side effects. The objective of this meta-analysis was to explore the role of NSAIDs in reducing postoperative pain at different time intervals and provide reference for medication after lumbar spine surgery by a meta-analysis of randomized controlled trials (RCT). Design: A meta-analysis study of randomized controlled trials. Setting: Postoperative recovery area. Patients: Adult patients who have undergone lumbar spine surgery. Intervention: Patients received NSAIDs for pain control after lumbar spine surgery. Measurements: Standardized mean difference (SMD) and 95%CI were used to evaluate the visual analog scale of postoperative pain. Main results: Four hundred and eight participants from eight studies were included in this study. The difference between the NSAIDs group and placebo is significant in 0-6, 12, and 24 h groups (overall: SMD = -0.72, 95%CI -0.98 to -0.45; 0-6 h: SMD = 0.50, 95%CI - 0.81 to -0.19;12 h: SMD = -1.07, 95%CI - 1.45 to -0.70; 24 h: SMD = -1.16, 95%CI - 1.87 to -0.45). Heterogeneity and publication bias were observed in the 0-6 and 24 h groups. Conclusion: NSAIDs are effective in postoperative analgesia after lumbar spine surgery. The study type, NSAID dose, different surgery types, and analgesic type might influence the efficacy of NSAIDs. (C) 2017 Elsevier Inc. All rights reserved.