A Cochrane review included 15 studies with a total of 1 101 children. The use of NSAIDs after paediatric tonsillectomy was associated with a non-significant increase in the risk of bleeding requiring surgical intervention compared with other analgesics or placebo (table ). NSAIDs did not significantly alter the number of perioperative bleeding events requiring non-surgical intervention. There was less vomiting when NSAIDs were used as part of the analgesic regime than when NSAIDs were not used.
| Outcome | Relative effect (95% CI) | Assumed risk - control | Corresponding risk – NSAID (95% CI) | Participants (studies) |
|---|---|---|---|---|
| Perioperative bleeding requiring surgical intervention | OR 1.69 (0.71 to 4.01) | 20 per 1000 | 33 per 1000 (14 to 76) | 1 044 (14 studies) |
| Perioperative bleeding requiring non-surgical intervention | OR 0.99 (0.41 to 2.4) | 50 per 1000 | 50 per 1000 (21 to 112) | 745 (10 studies) |
| Vomiting | RR 0.72 (0.61 to 0.85) | 357 per 1000 | 257 per 1000 (218 to 303) | 1 021 (13 studies) |