Effect of Parecoxib as an Adjunct to Patient-Controlled Epidural Analgesia after Abdominal Hysterectomy: A Multicenter, Randomized, Placebo-Controlled Trial

Liu, Weifeng; Shu, Haihua; Zhao, Guodong; Peng, Shu-Ling; Xiao, Jin-fang; Zhang, Guan-Rong; Liu, Ke-Xuan; Huang, Wenqi

doi:10.1371/journal.pone.0162589

Cited by 5 publications

(6 citation statements)

References 47 publications

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“…However, since no previous studies have been conducted comparing the impact of PCA and parecoxib, on daily activities no direct comparison of results is therefore possible. Notwithstanding, the positive effect of parecoxib use on physical activity observed in this study was consistent with findings of earlier reports, and adds to the growing body of literature on this topic ( 10 , 21 ). It is well known that morphine, or other opioids, is the most widely used intravenous drug for PCA, even as these common medications may be related to several adverse effects, such as nausea, vomiting, respiratory depression, sedation, constipation, confusion and urinary retention ( 8 , 9 ).…”

Section: Discussionsupporting

confidence: 93%

Parecoxib Reduced Postsurgical Pain and Facilitated Movement More Than Patient Controlled Analgesia

et al. 2022

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BackgroundPostoperative pain management is an imperative issue for patients undergoing lumbar spinal fusion surgery. Delayed pain relief is associated with poor clinical outcomes. This study compared the effects of intravenously administered patient-controlled analgesia (PCA) with intravenous parecoxib, both commonly used methods for analgesic pain control after surgery.MethodsA non-randomized study was used to recruit 68 patients who were scheduled to receive lumbar spinal fusion surgery at a hospital in Taiwan from April through December of 2020. The group treated with parecoxib received an initial perioperative dose of parecoxib 40 mg during a 30-min period and then postoperative intravenous parecoxib at 40 mg per 12-h period, for 72 h. Those with PCA received morphine (0.4 mg/ml), droperidol (0.02 mg/ml), diphenhydramine (0.48 mg/ml), midazolam (0.02 mg/ml) and saline solution during the 3-day study course. Major outcomes, including visual scale pain score and Barthel index of activities of daily living, were collected via review of medical records at 4 times: 12, 24, 48 and 72 h after surgery. Comparative effects between two groups were assessed by the generalized estimating equations.ResultsAfter adjusting for potential confounders, the administration of parecoxib was associated with a significant decrease in pain scores and an increase in the Barthel Index, when compared with the PCA group (all p < 0.05). Notably, both effects would maintain for 72 h after surgery.DiscussionThis is the first trial of which the authors are aware, that supports intravenous parecoxib as significantly enhancing patient mobility, in addition to having pain control efficacy, when compared with PCA. This study could be used as a reference when instituting interventions to improve the adaptation process and clinical prognoses after lumbar spinal fusion surgery.

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Section: Discussionsupporting

confidence: 93%

Parecoxib Reduced Postsurgical Pain and Facilitated Movement More Than Patient Controlled Analgesia

et al. 2022

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“…Parecoxib is used mostly for short-term perioperative pain control, and a recent clinical trial reported that pre-emptive administration of parecoxib can significantly reduce the risk of ipsilateral shoulder pain after thoracotomy. 4 Although the efficacy of pre-emptive analgesia with intravenous parecoxib has been well described, [4][5][6][7][8][9] its correlation with the Strengths and limitations of this study ► Latent curve analysis revealed the complex relationship between dynamic changes of postoperative pain scores over time, various types of analgesic modalities and patient characteristics in the clinical setting of video-assisted thoracoscopic surgery. ► It is noted that parecoxib mainly exerted its preemptive analgesic effects on the baseline value rather than decreasing rate of postoperative pain scores.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating the association of preoperative parecoxib with acute pain trajectories after video-assisted thoracoscopic surgery: a single-centre cohort study in Taiwan

Ling

Tai

et al. 2021

BMJ Open

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ObjectiveThe efficacy of parecoxib as pre-emptive analgesia still remains controversial. This study aimed to investigate how pre-emptive analgesia with parecoxib affected postoperative pain trajectories over time in patients undergoing thoracic surgery.DesignRetrospective cohort study.SettingA single medical centre in Taiwan.ParticipantsWe collected 515 patients undergoing video-assisted thoracoscopic surgery at a tertiary medical centre between September 2016 and August 2017.InterventionsPre-emptive parecoxib before surgery.Primary and secondary outcome measuresDaily numeric rating pain scores in the first postoperative week.ResultsA total of 196 (38.1%) of the recruited patients received parecoxib preoperatively. The latent curve analysis revealed that woman, higher body weight and postoperative use of parecoxib were associated with increased baseline level of pain scores over time (p=0.035, 0.005 and 0.048, respectively) but epidural analgesia and preoperative use of parecoxib were inclined to decrease it (both p<0.001). Regarding the decreasing trends of changes in daily pain scores, older age and epidural analgesia tended to steepen the slope (p=0.014 and <0.001, respectively). Preoperative use of parecoxib were also related to decreased frequency of rescue morphine medication (HR=0.4; 95% CI 0.25 to 0.65).ConclusionsPre-emptive analgesia with parecoxib was associated with decreased baseline pain scores but had no connection with pain decreasing trends over time. Latent curve analysis provided insights into the dynamic relationships among the analgesic modalities, patient characteristics and postoperative pain trajectories.

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“…Adjunctive parecoxib during morphine combined with ropivacaine epidural PCA (PCEA) following abdominal hysterectomy is safe and efficacious in reducing pain [9]. e combination of dexmedetomidine and sufentanil for intravenous PCA (PCIA) after abdominal operation could reduce sufentanil consumption, decrease visual analogue scale (VAS) scores, lower the rate of nausea and vomiting, and improve patient satisfaction [10].…”

Section: Introductionmentioning

confidence: 99%

Study on Main Drugs and Drug Combinations of Patient-Controlled Analgesia Based on Text Mining

Jin

2020

Pain Research and Management

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In recent years, with the continuous understanding of pain knowledge and the continuous improvement of quality of life requirements, patient-controlled analgesia (PCA) has been widely used in a variety of pain patients. In this study, text mining technology was used to analyze relevant literature, try to find out the main drugs of PCA, classify the drugs, and dig out the important drug combination rules. PCA studies were retrieved from PubMed database in recent 10 years, and the bibliographic information of the literatures was taken as mining sample. First, the names of the drugs in the sample were identified by MetaMap package; then, Bicomb software was used to extract high-frequency drugs for the word frequency analysis and to construct a drug-sentence matrix. Finally, “hclust” package and “arules” package of R were used for the cluster analysis and association analysis of drugs. 39 main PCA drugs were screened out. Morphine, dexmedetomidine, and fentanyl were the top three drugs. Through cluster analysis, these drugs were divided into two clusters, one containing 26 common drugs and the other containing 13 core drugs. The association analysis of these drugs was carried out, and 22 frequent itemsets and 6 association rules were obtained. The maximum frequent 1-itemset was {Morphine} and the maximum frequent 2-itemset was {Morphine, Ropivacaine}. The research results have certain guidance and reference value for clinicians and researchers. In addition, it provides a way to study the relationship between drugs from the perspective of text mining.

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Effect of Parecoxib as an Adjunct to Patient-Controlled Epidural Analgesia after Abdominal Hysterectomy: A Multicenter, Randomized, Placebo-Controlled Trial

Cited by 5 publications

References 47 publications

Parecoxib Reduced Postsurgical Pain and Facilitated Movement More Than Patient Controlled Analgesia

Parecoxib Reduced Postsurgical Pain and Facilitated Movement More Than Patient Controlled Analgesia

Evaluating the association of preoperative parecoxib with acute pain trajectories after video-assisted thoracoscopic surgery: a single-centre cohort study in Taiwan

Study on Main Drugs and Drug Combinations of Patient-Controlled Analgesia Based on Text Mining

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