Systematic ReviewResearchMedication Safety

Perioperative COX-2 inhibitors reduced acute pain interference with daily function

Anesthesiology (PubMed)Sep 9, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review and meta-analysis of randomized trials found that perioperative selective COX-2 inhibitors likely produced a clinically meaningful reduction in acute pain-related interference with daily function.

What NurseJet pulled from the source

Across 38 randomized trials with 5,424 participants, selective COX-2 inhibitors reduced acute pain interference by 1.1 points on a 0-to-10 Brief Pain Inventory scale, meeting the review's 1-point threshold for minimal clinical importance. Evidence certainty for this outcome was moderate.

Why this matters for nurses

Pain scores alone can miss how postoperative pain limits movement and daily activity. This review focused on functional interference and suggests a measurable benefit from selective COX-2 inhibitors while preserving uncertainty around longer-term outcomes and uncommon harms.

Bedside takeaway

Pair pain scores with functional assessment and monitor response within the ordered multimodal analgesia plan.

Key takeaways

The acute pain-interference estimate was based on seven trials and favored selective COX-2 inhibitors (mean difference -1.1, 95% CI -1.4 to -0.8).
Chronic pain incidence was lower in five trials, but certainty was low; chronic pain intensity was not significantly different in the single trial reporting it.
Quality of recovery improved slightly with low-certainty evidence, and the review found no differences in the other reported adverse events.

Practice implications

Assess both pain intensity and pain-related function after surgery, and monitor medication response and contraindications according to the ordered multimodal analgesia plan and local protocol.

Limitations & cautions

Abstract-only summary. Chronic pain, quality-of-recovery, and adverse-event findings were supported by low- or very-low-certainty evidence, and the abstract does not describe results by specific drug, dose, or operation.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Anesthesiology (PubMed)

Anesthesiology (PubMed). Effectiveness of Selective Cyclooxygenase-2 Inhibitors for Postoperative Pain Management Using Multidimensional Pain Assessment: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42708838/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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The Canadian journal of hospital pharmacy (PubMed)Sep 9, 2026Systematic Review

A systematic review and meta-analysis of five placebo-controlled randomized trials found lower mortality with intravenous hydrocortisone among neonates with hypotension, but the evidence base included only 239 patients.

Peds ICUAI summaryReview source

Systematic ReviewResearchMedication SafetyAI summary · original source linked below

The fixed-effect meta-analysis found an odds ratio for all-cause mortality of 0.48 with intravenous hydrocortisone versus placebo (95% CI 0.24 to 0.96), with low statistical heterogeneity. The authors state that larger trials are needed before the finding is considered confirmed.

Key takeaways

Five randomized, placebo-controlled trials with a total of 239 neonates were included.
The pooled mortality estimate favored hydrocortisone, but the confidence interval approached no difference.
The abstract addresses mortality only and does not provide pooled adverse-event or longer-term neurodevelopmental outcomes.

Why this matters on shift

Hydrocortisone may be considered when neonatal hypotension persists despite volume and vasoactive support, but this mortality signal comes from a small evidence base and should not be presented as definitive.

Bedside takeaway

Treat the mortality signal as promising but preliminary, and follow local NICU monitoring and escalation protocols.

Nursing implications

When hydrocortisone is ordered for refractory neonatal hypotension, continue close hemodynamic and medication monitoring and follow the NICU's dosing, glucose, electrolyte, and escalation protocols.

Limitations & cautions

Abstract-only summary. Only five trials and 239 neonates were pooled; the abstract does not report gestational-age subgroups, dosing differences, adverse events, or neurodevelopmental outcomes.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

The Canadian journal of hospital pharmacy (PubMed). Effect of IV Hydrocortisone on Mortality among Neonates with Hypotension: A Systematic Review and Meta-analysis of Randomized, Placebo-Controlled Trials.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Harvard review of psychiatry (PubMed)Sep 9, 2026Systematic Review

A systematic review and meta-analysis of seven randomized trials found that MDMA-assisted therapy may improve PTSD symptoms, dissociation, depression, and functional impairment compared with psychotherapy plus placebo or low-dose MDMA.

Psych Med-SurgAI summaryReview source

Systematic ReviewResearchMedication SafetyPatient EducationAI summary · original source linked below

The review included seven published and unpublished randomized trials identified through June 2025. Sleep quality did not improve, and the authors highlighted small samples, difficult blinding, nonstandardized psychotherapy, and common sponsorship across all trials.

Key takeaways

The pooled evidence favored MDMA-assisted therapy for core PTSD symptoms and several associated outcomes.
No benefit was found for sleep quality.
All trials shared a common sponsor, and psychedelic effects make participant and clinician blinding difficult.

Why this matters on shift

The findings help clinicians understand an emerging PTSD treatment evidence base while underscoring why symptom improvement in tightly controlled trials should not be equated with established routine practice.

Bedside takeaway

Frame MDMA-assisted therapy as emerging evidence with important blinding, sponsorship, and implementation limits.

Nursing implications

Use the findings for informed discussion and monitoring awareness, not independent treatment advice; follow current law, approved indications, specialist oversight, and facility policy.

Limitations & cautions

Abstract-only summary. The review included seven trials, some with small samples, and was limited by blinding challenges, nonstandardized psychotherapies, and a shared sponsor; the abstract does not report pooled effect sizes or adverse-event estimates.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Harvard review of psychiatry (PubMed). MDMA-Assisted Therapy May Decrease PTSD Symptoms, Dissociation, Depression, and Functional Disability: A Systematic Review and Meta-Analysis.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Neurosurgical review (PubMed)Sep 8, 2026Systematic Review

A meta-analysis of seven randomized trials found that middle meningeal artery embolization added to standard therapy reduced recurrent or residual chronic subdural hematoma and reoperation without a detected increase in serious adverse events.

Emergency GeriatricsAI summaryReview source

Systematic ReviewResearchAI summary · original source linked below

Among 1,889 adults, adjunctive embolization reduced recurrent or residual hematoma (risk ratio 0.63, 95% CI 0.46 to 0.85) and reoperation (risk ratio 0.39, 95% CI 0.28 to 0.56). Mortality, neurologic death, poor functional outcomes, and serious adverse events did not differ significantly.

Key takeaways

Seven randomized controlled trials were included.
Benefits for recurrence and reoperation were consistent across the review's timing, age, and follow-up subgroup analyses.
Hematoma resorption was not significantly different, and longer follow-up is needed to define durability and optimal use.

Why this matters on shift

Older adults with chronic subdural hematoma are vulnerable to recurrence and repeat procedures. The pooled trials support embolization as an adjunct that may reduce both, while not showing a functional or survival advantage.

Bedside takeaway

Continue neurologic and post-procedure monitoring even when embolization is added to reduce recurrence risk.

Nursing implications

For patients receiving embolization plus standard care, continue ordered neurologic checks and post-procedure monitoring and escalate changes according to local neurovascular and antithrombotic protocols.

Limitations & cautions

Abstract-only summary. The analysis pooled seven trials with varying treatment timing and follow-up; no mortality or functional-outcome benefit was detected, and longer-term outcomes remain uncertain.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Neurosurgical review (PubMed). Efficacy and safety of middle meningeal artery embolization for chronic subdural hematoma: an updated systematic review and meta-analysis focusing on time of intervention.

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AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

Small neonatal trials suggest hydrocortisone may reduce mortality in refractory hypotension

MDMA-assisted therapy may improve several PTSD outcomes, but trial limitations remain

Adjunctive middle meningeal artery embolization reduced chronic subdural recurrence