Following sinonasal surgery, NSAIDs-treated patients reported fewer side effects, a lower need for rescue drugs, and improved pain scores, according to a systematic review and meta-analysis. The effectiveness and safety of NSAIDs in individuals undergoing sinonasal surgery was the aim of the investigation.

Electronic databases such as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and the WHO International Clinical Trials Registry Platform were explored. Comparative observational studies and randomized controlled trials (RCTs) in any language were taken into consideration.

Data extraction, risk of bias evaluation, and screening were carried out. Postoperative pain scores, the need for rescue analgesia, and postoperative adverse events (vomiting/nausea, epistaxis) were the outcomes. Fifteen RCTs (with 1,210 participants) and 2 observational studies were incorporated among 4,661 records.

There was no difference in pain scores between the NSAIDs group and the non-NSAIDs group following endoscopic sinus surgery (standardized mean differences [SMD] 0.44 units better). NSAIDs reduced pain scores during septorhinoplasty compared to non-NSAID regimens (SMD 1.14 units better).

At a relative risk (RR) of 0.45, NSAIDs minimized the requirement for rescue medicine. Moreover, NSAIDs did not raise the risk of epistaxis (RR 0.72) while decreasing the risk of nausea with an RR of 0.62. Hence, the findings offered strong evidence to support NSAIDs consideration for individuals undergoing routine sinonasal surgery.