Prague Med. Rep. 2026, 127, 3-14

https://doi.org/10.14712/23362936.2026.1

Comparative Effectiveness of Nonsteroidal Anti-inflammatory Drugs and Glucocorticoids in Managing Postoperative Pain Syndrome

Medina Jeenbaeva1ID, Akylbek Shakirov2ID, Ibragim Atabaev1ID, Akylbek Burkanov1ID, Zarema Boronchieva1ID

1Department of Basic and Clinical Pharmacology, Osh State University, Osh, Kyrgyz Republic
2Department of Traumatology Forensic Medicine with a Course in Radiation Diagnostics, Osh State University, Osh, Kyrgyz Republic

Received May 22, 2025
Accepted February 26, 2026

References

1. Abdildin, Y., Tapinova, K., Salamat, A., Shaimakhanov, R., Aitbayev, A., Viderman, D. (2023) Rectus sheath block in abdominal surgery: A systematic review with meta-analysis. Rom. J. Anaest. Intensive Care 30(1), 43–50.
2. Abushanab, D., Al-Badriyeh, D. (2021) Efficacy and safety of ibuprofen plus paracetamol in a fixed-dose combination for acute postoperative pain in adults: Meta-analysis and a trial sequential analysis. CNS Drugs 35(1), 105–120. <https://doi.org/10.1007/s40263-020-00777-7>
3. Aliyev, D., Asik, I. (2023) Postoperative chronic pain syndrome and risk factors in patients with breast surgery. J. Coll. Physicians Surg. Pak. 33(6), 609–615.
4. Alshelh, Z., Brusaferri, L., Saha, A., Morrissey, E., Knight, P., Kim, M., Zhang, Y., Hooker, J. M., Albrecht, D., Torrado-Carvajal, A., Placzek, M. S., Akeju, O., Price, J., Edwards, R. R., Lee, J., Sclocco, R., Catana, C., Napadow, V., Loggia, M. L. (2022) Neuroimmune signatures in chronic low back pain subtypes. Brain 145(3), 1098–1110. <https://doi.org/10.1093/brain/awab336>
5. Anger, M., Valovska, T., Beloeil, H., Joshi, G. P., Van de Velde, M., Raeder, J.; PROSPECT Working Group* and the European Society of Regional Anaesthesia and Pain Therapy (2021) PROSPECT guideline for total hip arthroplasty: A systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia 4(1), 1082–1097. <https://doi.org/10.1111/anae.15498>
6. Arapbaevna, K. Z., Ardak, A., Abzhanovna, A. G., Bahitkerevna, D. A., Uringalievna, B. A., Izbasarovna, K. E., Malikovna, D. A., Erbolovna, D. A. (2021) Modern diagnostic approaches for early detection of antiphospholipid syndrome. Arch. Venez. Farmacol. Ter. 40(2), 178–186.
7. Arslan, D., Ünal Çevik, I. (2022) Interactions between the painful disorders and the autonomic nervous system. Agri 34(3), 155–165.
8. Berta, T., Qadri, Y., Tan, P.-H., Ji, R. R. (2017) Targeting dorsal root ganglia and primary sensory neurons for the treatment of chronic pain. Expert Opin. Ther. Targets 21(7), 695–703. <https://doi.org/10.1080/14728222.2017.1328057>
9. Cao, L., Yang, T., Hou, Y., Yong, S., Zhou, N. (2024) Efficacy and safety of different preemptive analgesia measures in pain management after laparoscopic cholecystectomy: A systematic review and network meta-analysis of randomized controlled trials. Pain Ther. 13(6), 1471–1497. <https://doi.org/10.1007/s40122-024-00647-w>
10. Chang, R. W., Tompkins, D. M., Cohn, S. M. (2021) Are NSAIDs safe? Assessing the risk-benefit profile of nonsteroidal anti-inflammatory drug use in postoperative pain management. Am. Surg. 87(6), 872–879. <https://doi.org/10.1177/0003134820952834>
11. Coşarcan, S. K., Yavuz, Y., Doğan, A. T., Erçelen, Ö. (2022) Can postoperative pain be prevented in bariatric surgery? Efficacy and usability of fascial plane blocks: A retrospective clinical study. Obes. Surg. 32(9), 2921–2929. <https://doi.org/10.1007/s11695-022-06184-9>
12. Dieu, A., Huynen, P., Lavand’homme, P., Beloeil, H., Freys, S., Pogatzki-Zahn, E., Joshi, G., Van de Velde, M.; PROSPECT Working Group of the European Society of Regional Anaesthesia and Pain Therapy (ESRA) (2021) Pain management after open liver resection: Procedure-specific postoperative pain management (PROSPECT) recommendations. Reg. Anesth. Pain Med. 46(5), 433–445. <https://doi.org/10.1136/rapm-2020-101933>
13. Efremov, A. (2025) The fear primacy hypothesis in the structure of emotional states: A systematic literature review. Psychol. Rep. (Epub ahead of print)
14. Gasbjerg, K., Hägi-Pedersen, D., Lunn, T., Laursen, C., Holmqvist, M., Vinstrup, L., Ammitzboell, M., Jakobsen, K., Jensen, M., Pallesen, M., Bagger, M., Lindholm, P., Pedersen, N., Schrøder, H., Lindberg-Larsen, M., Nørskov, A., Thybo, K., Brorson, S., Overgaard, S., Jakobsen, J., Mathiesen, O. (2022) Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: Randomised clinical trial. BMJ 4(376), e067325. <https://doi.org/10.1136/bmj-2021-067325>
15. Gau, T. P., Wu, S. H., Huang, J. M., Lu, W. L., Huang, T. Y., Lu, I. C., Wu, C. W. (2023) Multimodal analgesia with local wound infiltration and intravenous parecoxib for thyroidectomy. Medicina (Kaunas) 59(5), 855. <https://doi.org/10.3390/medicina59050855>
16. Ge, Z., Li, M., Chen, Y., Sun, Y., Zhang, R., Zhang, J., Bai, X., Zhang, Y., Chen, Q. (2023) The efficacy and safety of parecoxib multimodal preemptive analgesia in artificial joint replacement: A systematic review and meta-analysis of randomized controlled trials. Pain Ther. 12(4), 1065–1078. <https://doi.org/10.1007/s40122-023-00500-6>
17. Gupta, R., Van de Ven, T., Pyati, S. (2020) Post-thoracotomy pain: Current strategies for prevention and treatment. Drugs 80(16), 1677–1684. <https://doi.org/10.1007/s40265-020-01390-0>
18. Hald, P. P., Møller, A. M. (2024) Pain management in total knee arthroplasty. Ugeskr. Laeger 186(25), V10230664. (in Danish)
19. Han, C., Gan, D., Meng, C., Qiu, Y., Hao, T. (2024) Efficacy and safety of intra-articular glucocorticoid injection for postoperative pain control after knee arthroscopy: A systematic review. J. Orthop. Surg. Res. 19(1), 736. <https://doi.org/10.1186/s13018-024-05204-x>
20. Hardman, M., Olsen, D., Amundson, A. (2021) Multimodal analgesia decreases postoperative opioid consumption in living liver donation. Mayo Clin. Proc. Innov. Qual. Outcomes 5(3), 583–589. <https://doi.org/10.1016/j.mayocpiqo.2021.03.001>
21. Hobelmann, J. G., Huhn, A. S. (2021) Comprehensive pain management as a frontline treatment to address the opioid crisis. Brain Behav. 11(11), e2369. <https://doi.org/10.1002/brb3.2369>
22. Huang, H. J., Dang, H. H., Mamtimin, M., Yang, G., Zhang, X., Wang, J. Q. (2023) Hip arthroscopy for femoroacetabular impingement syndrome shows good outcomes and low revision rates, with young age and low postoperative pain score predicting excellent 5-year outcomes. Arthroscopy 39(2), 285–292. <https://doi.org/10.1016/j.arthro.2022.03.024>
23. Jiang, B., Ye, S. (2022) Pharmacotherapeutic pain management in patients undergoing laparoscopic cholecystectomy: A review. Adv. Clin. Exp. Med. 31(11), 1275–1288. <https://doi.org/10.17219/acem/151995>
24. Kaloshi, G., Roji, A., Seferi, A., Cakani, B., Bushati, T., Roci, E., Petrela, M. (2014) Spinal dissemination of intracranial glioblastoma in bevacizumab era: A potential bevacizumab-induced mechanism. Acta Inform. Med. 22(2), 142–144. <https://doi.org/10.5455/aim.2014.22.142-144>
25. Karaaslan, E., Akbas, S., Ozkan, A., Zayman, E. (2019) Effects of preemptive intravenous paracetamol and ibuprofen on headache and myalgia in patients after electroconvulsive therapy: A placebo-controlled, double-blind, randomized clinical trial. Medicine (Baltimore) 98(51), e18473. <https://doi.org/10.1097/MD.0000000000018473>
26. Kerimbayev, T., Kenzhegulov, Y., Tuigynov, Z., Aleinikov, V., Urunbayev, Y., Pan, A., Abishev, N., Oshayev, M., Baiskhanova, D., Solodovnikov, M., Akshulakov, S. (2022) Transforaminal endoscopic discectomy under general and local anesthesia: A single-center study. Front. Surg. 19(9), 873954. <https://doi.org/10.3389/fsurg.2022.873954>
27. Khezri, M., Mosallaei, M., Ebtehaj, M. (2018) Comparison of preemptive effect of intravenous ketorolac versus meperidine on postoperative shivering and pain in patients undergoing cesarean section under spinal anesthesia: A prospective, randomized, double-blind study. Caspian J. Intern. Med. 9(2), 151–157.
28. Latka, K., Kozlowska, K., Waligora, M., Kolodziej, W., Olbrycht, T., Chowaniec, J., Hendryk, S., Latka, M., Latka, D. (2021) Efficacy of DiscoGel in treatment of degenerative disc disease: A prospective 1-year observation of 67 patients. Brain Sci. 11(11), 1434. <https://doi.org/10.3390/brainsci11111434>
29. Latka, K., Kozlowska, K., Waligora, M., Kolodziej, W., Latka, D. (2023) Effect of DiscoGel treatment of the intervertebral disc at MRI. Clin. Radiol. 78(12), 928–934. <https://doi.org/10.1016/j.crad.2023.07.023>
30. Lisiecka, M. Z. (2024a) Evolution, mechanism of action, and clinical applications of three generations of antihistamines. Innovaciencia 12(1), e3651. <https://doi.org/10.15649/2346075X.3651>
31. Lisiecka, M. Z. (2024b) Side effects and hypersensitivity reactions to corticosteroids. Med. Perspekt. 29(1), 95–104. <https://doi.org/10.26641/2307-0404.2024.2.307587>
32. Machado, J. R. U., Maldonado, C. B. V., Zambrano, N. S. B. (2024) Unnecessary caesarean section? A bioethical vision at this birth modality in Chile and Venezuela. :Gac. Med. Caracas 132(1), 208–224.
33. Malik, A., Elshazly, T., Pokuri, K., Apai, C., Rothkrug, A., Hasoon, J., Chung, M., Ye, Z., Bhayani, S., Kaye, S., Liu, H., Lang, M., Yong, R. J., Donjow, A., Varrassi, G., Robinson, G. (2024) Virtual reality for postoperative pain management: A review of current evidence. Curr. Pain Headache Rep. 28(12), 1307–1319. <https://doi.org/10.1007/s11916-024-01308-5>
34. Maloney, J., Wie, C., Pew, S., Covington, S., Maita, M., Kozinn, R., Sabin, M., Freeman, J., Kraus, M., Strand, N. (2022) Post-thoracotomy pain syndrome. Curr. Pain Headache Rep. 26(9), 677–681. <https://doi.org/10.1007/s11916-022-01069-z>
35. Mao, Y., Wu, L., Ding, W. (2016) The efficacy of preoperative administration of gabapentin/pregabalin in improving pain after total hip arthroplasty: A meta-analysis. BMC Musculoskelet. Disord. 17(1), 373. <https://doi.org/10.1186/s12891-016-1231-4>
36. McQuay, H. J., Moore, R. A., Berta, A., Gainutdinovs, O., Fülesdi, B., Porvaneckas, N., Petronis, S., Mitkovic, M., Bucsi, L., Samson, L., Zegunis, V., Ankin, M., Bertolotti, M., Pizà-Vallespir, B., Cuadripani, S., Contini, M., Nizzardo, A. (2016) Randomized clinical trial of dexketoprofen/tramadol 25 mg/75 mg in moderate-to-severe pain after total hip arthroplasty. Br. J. Anaesth. 116(2), 269–276. <https://doi.org/10.1093/bja/aev457>
37. Mirzakhmetova, D., Kamkhen, V., Akhmetzhanova, Z., Sarmuldayeva, S., Ayazbekov, A., Iskakova, F. (2024) Predictors associated with night sleep disturbance among breastfeeding women. Prev. Med. 185, 108011. <https://doi.org/10.1016/j.ypmed.2024.108011>
38. Missori, P., Domenicucci, M., Paolini, S., Mancarella, C., Tola, S., D’Elia, A., Marotta, N., Seferi, A., Esposito, V. (2016) Emergency decompressive craniectomy after removal of convexity meningiomas. Surg. Neurol. Int. 7(1), 193098. <https://doi.org/10.4103/2152-7806.193098>
39. Navarro-Obeid, J., Lhoeste-Charris, Á., Orozco Santander, M., González, C. Á., Delbono, L. C., Sierra, B. S., Zurita-Caraballo, M. (2025) A systematic review of psychological and physical factors associated with fibromyalgia. Gac. Med. Caracas 133(Supl. 1), S273–S285. <https://doi.org/10.47307/GMC.2025.133.s1.24>
40. Neumann-Podczaska, A., Tobis, S., Yermukhanova, L., Wieczorowska-Tobis, K. (2019) Pain in advanced stages of dementia: The perspective of medical students. Medicina (Kaunas) 55(5), 116. <https://doi.org/10.3390/medicina55050116>
41. Nuspekova, D., Doskaliyev, A., Dzhumabekov, A., Akilov, K., Dossan, A. (2024) Application of biotechnologies in the treatment of haemorrhoidal disease and optimisation of patient management. Prz. Gastroenterol. 19(2), 127–134.
42. Pergolizzi, J., LeQuang, J., Magnusson, P., Varrassi, G. (2023) Identifying risk factors for chronic postsurgical pain and preventive measures: A comprehensive update. Expert Rev. Neurother. 23(12), 1297–1310. <https://doi.org/10.1080/14737175.2023.2284872>
43. Ranjbari, F., Alimohammadi, E. (2024) Unveiling the potential impact of vitamin C in postoperative spinal pain. Chin. Neurosurg. J. 10(1), 16. <https://doi.org/10.1186/s41016-024-00368-1>
44. Ross, J., Cole, C., Lo, W., Ura, M. (2021) Postoperative pain in thoracic surgical patients: An analysis of factors associated with acute and chronic pain. Heart Lung Circ. 30(8), 1244–1250. <https://doi.org/10.1016/j.hlc.2020.12.001>
45. Sagindykova, A. A., Bazylbekova, Z. O., Sagindykova, B. A. (2017) Ways of prognosis and reduction of obstetric and perinatal complications at pregnancy chronic pyelonephritis. Biomed. Pharmacol. J. 10(2), 535–547. <https://doi.org/10.13005/bpj/1139>
46. Sakaguchi, T., Gunjotikar, S., Tanaka, M., Komatsubara, T., Latka, K., Ekade, S. J., Prabhu, S. P., Takamatsu, K., Yasuda, Y., Nakagawa, M. (2024) Evaluation and rehabilitation after adult lumbar spine surgery. J. Clin. Med. 13(10), 2915. <https://doi.org/10.3390/jcm13102915>
47. Shetty, V., BhanuPrakash, B., Yadav, A., Kishore, N., Menon, A. (2020) Do regional nerve blocks before bimaxillary surgery reduce postoperative pain? J. Oral Maxillofac. Surg. 78(5), 724–730. <https://doi.org/10.1016/j.joms.2019.10.014>
48. Silva, A., Costa, B., Castro, I., Mourão, J., Vale, N. (2023) New perspective for drug-drug interaction in perioperative period. J. Clin. Med. 12(14), 4810. <https://doi.org/10.3390/jcm12144810>
49. Small, C., Laycock, H. (2020) Acute postoperative pain management. Br. J. Surg. 107(2), e70–e80. <https://doi.org/10.1002/bjs.11477>
50. Stormholt, E., Steiness, J., Derby, C., Larsen, M., Maagaard, M., Mathiesen, O. (2021) Paracetamol, non-steroidal anti-inflammatory drugs and glucocorticoids for postoperative pain: A protocol for a systematic review with meta-analysis and trial sequential analysis. Acta Anaesthesiol. Scand. 65(10), 1505–1513. <https://doi.org/10.1111/aas.13943>
51. Sydora, B., Whelan, L., Abelseth, B., Brar, G., Idris, S., Zhao, R., Leonard, A., Rosenbloom, B., Clarke, H., Katz, J., Beesoon, S., Rasic, N. (2024) Identification of presurgical risk factors for the development of chronic postsurgical pain in adults: A comprehensive umbrella review. J. Pain Res. 17, 2511–2530. <https://doi.org/10.2147/JPR.S466731>
52. Tobis, S., Neumann-Podczaska, A., Yermukhanova, L., Sultanova, G., Kurmanalina, G., Kimatova, K., Dworacka, M., Wieczorowska- Tobis, K. (2020) Pain in people with advanced dementia: The opinions of Kazakh medical students. J. Pain Res. 13, 3307–3314. <https://doi.org/10.2147/JPR.S276479>
53. Viderman, D., Tapinova, K., Dossov, M., Seitenov, S., Abdildin, Y. (2023) Virtual reality for pain management: An umbrella review. Front. Med. (Lausanne) 14(10), 1203670. <https://doi.org/10.3389/fmed.2023.1203670>
54. Viderman, D., Aubakirova, M., Salamat, A., Kaldybayev, D., Sadir, N., Tankacheyev, R., Abdildin, Y. (2024) The impact of gabapentinoids on pain-related outcomes after knee and hip surgery: A systematic review with meta-analysis of randomized controlled trials. J. Clin. Med. 13(14), 4205. <https://doi.org/10.3390/jcm13144205>
55. Vilai, P., Dhanachanvisith, N., Kongmalai, P. (2023) Efficacy of preemptive analgesia on tourniquet and postoperative pain relief in open carpal tunnel release: A prospective randomized control trial. J. Hand Surg. Am. 48(8), 828.e1–828.e7. <https://doi.org/10.1016/j.jhsa.2022.01.017>
56. Wang, R. D., Zhu, J. Y., Zhu, Y., Ge, Y. S., Xu, G. L., Jia, W. D. (2020) Perioperative analgesia with parecoxib sodium improves postoperative pain and immune function in patients undergoing hepatectomy for hepatocellular carcinoma. J. Eval. Clin. Pract. 26(3), 992–1000. <https://doi.org/10.1111/jep.13256>
57. Wang, W., Wang, Y., Lou, T., Ding, M., Li, J., Xiong, H., Yao, Z., Ma, Y., Chen, H., Liu, S. (2021) Celecoxib-loaded electrospun fibrous antiadhesion membranes reduce COX-2/PGE2 induced inflammation and epidural fibrosis in a rat failed back surgery syndrome model. Neural. Plast. 2021, 6684176.
58. Wu, Q., Cui, X., Guan, L. C., Zhang, C., Liu, J., Ford, N. C., He, S., Chen, X., Cao, X., Zang, L., Guan, Y. (2023) Chronic pain after spine surgery: Insights into pathogenesis, new treatment, and preventive therapy. J. Orthop. Translat. 42, 147–159. <https://doi.org/10.1016/j.jot.2023.07.003>
59. Zeng, A. M., Nami, N. F., Wu, C. L., Murphy, J. D. (2016) The analgesic efficacy of nonsteroidal anti-inflammatory agents (NSAIDs) in patients undergoing cesarean deliveries: A meta-analysis. Reg. Anesth. Pain Med. 41(6), 763–772. <https://doi.org/10.1097/AAP.0000000000000460>
60. Zhaksylyk, A., Abdildin, Y., Sultangazin, S., Zhumakanova, A., Viderman, D. (2024) The impact of ketamine on pain-related outcomes after thoracotomy: A systematic review with meta-analysis of randomized controlled trials. Front. Med. (Lausanne) 11, 1394219. <https://doi.org/10.3389/fmed.2024.1394219>
61. Zufferey, P., Chaux, R., Lachaud, P., Capdevila, X., Lanoiselée, J., Ollier, E. (2024) Dose-response relationships of intravenous and perineural dexamethasone as adjuvants to peripheral nerve blocks: A systematic review and model-based network meta-analysis. Br. J. Anaesth. 132(5), 1122–1132. <https://doi.org/10.1016/j.bja.2023.12.021>
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