(1302) Administration of Perioperative Celecoxib Reduces Opioid Consumption After Soft Palate Surgery for Obstructive Sleep Apnea

Introduction: Postoperative opioids pose multiple risks for patients undergoing upper airway surgery for obstructive sleep apnea (OSA). Perioperative administration of celecoxib and acetaminophen may reduce postsurgical pain, but it is unknown whether these medications are associated with decreased opioid consumption after OSA surgery. The objective of this study was to examine the association between perioperative celecoxib and acetaminophen administration and opioid consumption in the first 24 hours after palate surgery for OSA.

Methods: A retrospective cohort study of opioid-naïve adults with OSA undergoing soft palate surgery and admitted to the hospital postoperatively between July 2013 and June 2023 was performed. Study participants were included if they underwent concurrent nasal surgery but excluded if they underwent any other pharyngeal surgery. Opioids administered after surgery were converted to morphine milligram equivalents (MME). Multiple linear regression was used to examine the association between total MME consumed in the first 24 hours postoperatively and celecoxib and acetaminophen usage.

Results: A total of 210 study participants (16% female) were included with mean age of 48.7 ± 37.5 years. Mean MME consumed per patient was 80.2 ± 63.9. Of the total, 84 (40%) patients received perioperative celecoxib, while 195 (93%) received perioperative acetaminophen. Celecoxib use was associated with lesser MME (-2.71 ± 1.07 MME per 100 mg; p=0.012) consumed postoperatively, while acetaminophen was not (-0.28 ± 0.32 MME per 100 mg; p = 0.38). Female gender (p = 0.048), Asian race (p < 0.001), and Black race (p = 0.025) were also associated with lesser MME consumed postoperatively, while autoimmune conditions (p = 0.002) and tonsillectomy (p = 0.024) were associated with greater MME consumption.

Conclusions: Perioperative celecoxib was associated with reduced MME consumption after palate surgery. No association was found between acetaminophen administration and postoperative opioid use.