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Peer-reviewedCC BY 4.0The Journal of Laryngology and Otology

The safety of selective COX-2 inhibitors in tonsillectomy patients: a systematic review

  • Sophie Dunmall1,2
  • Lucylynn Lizarondo2
  • Romy Jia2
  • Eng Hooi Ooi3
  1. 1Flinders Medical Centre, Australia
  2. 2JBI Adelaide, Australia
  3. 3Otolaryngology Head and Neck Surgery, Flinders Medical Centre, Australia
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Abstract

Objectives: This study aimed to determine the safety of selective cyclooxygenase 2 inhibitors in tonsillectomy patients.

Methods: A systematic review of the literature was undertaken in August 2024 (updated March 2025) using Joanna Briggs Institute systematic review and critical appraisal methodology. Study outcomes were bleeding incidence, analgesic efficacy and adverse effects. Eligible comparators were non–cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs or placebo.

Results: Fifteen studies were included for meta-analysis, 14 of which were randomised control trials. The studies were overall of good quality. There was no increased risk of bleeding with selective cyclooxygenase 2 inhibitors (odds ratio = 1.27; 95 per cent confidence interval: 0.51 to 3.16; p = 0.61). They were more effective than placebo in providing analgesia (odds ratio = -1.22; 95 per cent confidence interval, -2.12 to -0.33; Z = 2.67; p = 0.007; I2 = 84 per cent).

Conclusion: Selective cyclooxygenase 2 inhibitors do not cause an increase in bleeding risk for tonsillectomy patients. There is insufficient evidence to compare their safety and efficacy to non-selective non-steroidal anti-inflammatory drugs such as ibuprofen.

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Cite

BibTeXRIS
BibTeX
@article{dunmall2026safety,
  title = {{The safety of selective COX-2 inhibitors in tonsillectomy patients: a systematic review}},
  author = {Sophie Dunmall and Lucylynn Lizarondo and Romy Jia and Eng Hooi Ooi},
  journal = {The Journal of Laryngology and Otology},
  year = {2026},
  month = nov,
  doi = {10.1017/s0022215126105039},
  url = {https://doi.org/10.1017/s0022215126105039},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The safety of selective COX-2 inhibitors in tonsillectomy patients: a systematic review
AU  - Sophie Dunmall
AU  - Lucylynn Lizarondo
AU  - Romy Jia
AU  - Eng Hooi Ooi
PY  - 2026
DA  - 2026/11/06
JO  - The Journal of Laryngology and Otology
DO  - 10.1017/s0022215126105039
UR  - https://doi.org/10.1017/s0022215126105039
AB  - Objectives: This study aimed to determine the safety of selective cyclooxygenase 2 inhibitors in tonsillectomy patients.  Methods: A systematic review of the literature was undertaken in August 2024 (updated March 2025) using Joanna Briggs Institute systematic review and critical appraisal methodology. Study outcomes were bleeding incidence, analgesic efficacy and adverse effects. Eligible comparators were non–cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs or placebo.  Results: Fifteen studies were included for meta-analysis, 14 of which were randomised control trials. The studies were overall of good quality. There was no increased risk of bleeding with selective cyclooxygenase 2 inhibitors (odds ratio = 1.27; 95 per cent confidence interval: 0.51 to 3.16; p = 0.61). They were more effective than placebo in providing analgesia (odds ratio = -1.22; 95 per cent confidence interval, -2.12 to -0.33; Z = 2.67; p = 0.007; I2 = 84 per cent).  Conclusion: Selective cyclooxygenase 2 inhibitors do not cause an increase in bleeding risk for tonsillectomy patients. There is insufficient evidence to compare their safety and efficacy to non-selective non-steroidal anti-inflammatory drugs such as ibuprofen.
SN  - 0022-2151
SN  - 1748-5460
ER  -