Carpenter PS, et al. - Authors probed the relationship of celecoxib use with opioid requirements in the postoperative setting after head and neck cancer (HNC) surgery with free tissue reconstruction. They noted an association of the use of celecoxib after head and neck cancer surgery and reconstruction with free tissue transfer with a decrease in oral, IV, and total opioid requirements without increasing surgical or flap-related complications.

Methods

• Experts conducted a retrospective, matched-cohort study of 147 patients who had undergone HNC surgery with free tissue reconstruction between June 2015 and Sept 2017 in an academic cancer hospital.
• They separated the patients into groups based on if celecoxib had been used perioperatively or not.
• They then matched these groups by stage and site resulting in 102 included participants (51 celecoxib, 51 control).
• Main outcomes and measures were the oral, intravenous (IV), and total morphine equivalents used in the postoperative setting per patient per day.

Results

• As per the findings, there were 51 patients in the celecoxib cohort (19 women and 32 men) and 51 patients in the control cohort (20 women and 31 men) who met inclusion criteria after clinicopathologic data were matched.
• Findings suggested that 61.6 years and 66.1 years was the mean age of the celecoxib and control cohorts, respectively.
• In the postoperative setting, treatment with celecoxib was related to decreased mean use of opioids in oral (mean difference, 9.9 mg/d; 95% CI, -1.2 to 21.1), IV (mean difference, 3.9 mg/d; 95% CI, 1.0-6.8), and total (mean difference, 14 mg/d; 95% CI, 2.6-25.4) amount of morphine equivalents per day.
• The effect was more significant, when patients were matched to surgical procedure.
• Results demonstrated that patients who underwent composite oral resection and received celecoxib had decreased opioid use in oral (mean difference, 25 mg/d; 95% CI, 12.5-25.4), IV (mean difference, 3.4 mg/d; 95% CI, 1.5-5.5), and total (mean difference, 28.4 mg/d; 95% CI, 15.7-41.5) amounts vs those in the control group.
• Between the 2 cohorts, there was no significant difference in complication rates.