Post-Thyroidectomy Complications Associated with NSAID Use

Sunday, October 12, 2025

3:18 PM - 3:24 PM EDT

Location: 128

Introduction: In 2021, the American Academy of Otolaryngology released guidelines encouraging multimodal treatment of postoperative pain with nonopioid analgesics as first-line therapy. The purpose of this study was to compare post-thyroidectomy complication profiles between patients receiving opioids alone and those receiving opioids in combination with nonsteroidal anti-inflammatory drugs (NSAIDs).

Methods: A retrospective study was conducted within the TriNetX US Collaborative Network. Patients aged 18 years or older who underwent partial, total, or completion thyroidectomy between January 2006 and December 2024 were identified using relevant procedural codes. Two cohorts were created: those receiving opioid analgesics alone (OA) and those receiving opioid analgesics in combination with NSAIDs including ibuprofen, ketorolac, acetylsalicylic acid, naproxen, or celecoxib (ON), within two weeks post-thyroidectomy. Propensity score matching was performed to balance cohorts by age at thyroidectomy, sex, race, and ethnicity. Post-thyroidectomy outcomes and complications within two weeks of surgery were analyzed, including hematoma formation, postoperative hemorrhage, pain, hypocalcemia, and infection.

Results: A total of 40255 thyroidectomy patients in the ON group were matched with an equal number of patients in the OA group (mean age 52.9±15.1 years). ON patients were more likely to develop hematoma compared to OA patients (N=286, 0.7% vs. N=217, 0.5%; OR=1.32, 95% CI=1.11-1.58, p=.002). No significant difference was observed in postoperative bleeding rates (N=185, 0.5% vs. N=174, 0.4%, p=.56). ON patients were more likely to have documented pain (N=197, 0.5% vs. N=105, 0.3%; OR=1.88, 95% CI=1.48-2.38, p<.001), hypocalcemia (N=2647, 6.6% vs. N=2289, 5.7%; OR=1.17, 95% CI=1.10-1.24, p<.001), and infection (N=305, 0.8% vs. N=136, 0.3%; OR=2.25, 95% CI=1.83-2.76, p<.001).

Conclusions: NSAIDs are associated with slightly increased complications post-thyroidectomy. Further research is needed to explore the underlying mechanisms of this association.

Presenting Author(s)

Deepthi S. Akella, DO, MS

Resident Physician
University of Missouri Department of Otolaryngology
Columbia, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

GV

Gaayathri Varavenkataraman, MA

Research Assistant
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
East Amherst, New York, United States

Disclosure information not submitted.
Alexandra F. Corbin, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Alex P. Bogosian, BS

Medical Student
Touro College of Osteopathic Medicine- Middletown
Buffalo , New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Katelin R. Keenehan, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Rochester, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MC

Michele M. Carr, DDS MD PhD

Professor
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, New York, United States

Disclosure information not submitted.