Background Recurrent spontaneous pneumothorax iswidely treated by video-assisted thoracoscopic (VATS)bullectomy and pleurodesis. Treatment of postoperativepain with nonsteroidal antiinflammatory drugs (NSAIDs) iscontroversial as many surgeons believe that it reduces theefficacy of pleurodesis and increases the pneumothoraxrecurrence rate.Methods In this retrospective study, we reviewed thehospital records for patients following VATS pleurodesisfor recurrent spontaneous pneumothorax. The patients weredivided into two groups: (1) NSAID group: patients weretreated with NSAIDs for more than a week followingsurgery and (2) control group: patients did not receiveNSAIDs. Data regarding short- and long-term outcomeswere compared.Results The study cohort included 105 patients: 48 in theNSAID group and 57 in the control group. During the earlypostoperative period the average daily requirement ofnarcotic analgesia and the incidence of narcotic-relatedside effects were lower in the NSAIDs group. No differencewas found in the long-term recurrence rate: two of 48(4%) in the NSAID group and three of 57 (5%) in thecontrol group. There was one case of early recurrence inthe NSAID group. Both groups had similar length of staywith no cases of mortality or major morbidity.Conclusions NSAIDs for postsurgical pleurodesis painobviates the need for narcotics without increasing thepneumothorax recurrence rate. Prospective randomizedcontrolled studies are needed to further investigate this issue.
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