Effect of Parecoxib on Postoperative Pain After Lumbar Spine Surgery

Jirarattanaphochai, Kitti; Thienthong, Somboon; Sriraj, Wimonrat; Jung, Surachai; Pulnitiporn, Aksorn; Lertsinudom, Somkid; Foocharoen, Thanit

doi:10.1097/brs.0b013e3181604529

Cited by 60 publications

(18 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However the concept that preemptive analgesia is more effective than conventional regimens in managing acute postoperative pain remains controversial [ 32 ]. There are many available analgesic interventions for possible preemptive analgesia effects in lumbar spinal surgery including epidural analgesia [ 36 ], local anesthetic wound infiltration [ 37 ], systemic opioids [ 38 ] and systemic NSAID drugs [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing parecoxib and ketorolac as preemptive analgesia in patients undergoing posterior lumbar spinal fusion: a prospective randomized double-blinded placebo-controlled trial

Siribumrungwong

Cheewakidakarn

Tangtrakulwanich

et al. 2015

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundPoor postoperative pain control is frequently associated with complications and delayed discharge from a hospital. Preemptive analgesia is one of the methods suggested for reducing postoperative pain. Opioids are effective for pain control, but there known addictive properties make physicians cautious about using them. Parecoxib and ketorolac are potent non-opioid NSAIDs that are attractive alternative drugs to opioids to avoid opioid-related side effects. However, there are no good head-to-head comparisons between these two drugs in the aspect of preemptive analgesic effects in lumbar spinal fusion surgery. This study aimed to compare the efficacy in terms of postoperative pain control and safety of parecoxib with ketorolac as preemptive analgesia in posterior lumbar spinal fusion patients.MethodsA prospective, double-blinded randomized controlled trial was carried out in patients undergoing posterior lumbar spinal fusion, who were randomized into 3 groups (n = 32). Parecoxib, ketorolac or a placebo was given to each patient via injection around 30 minutes prior to incision. The efficacy of postoperative pain control was assessed by a verbal numerical rating score (0–10). And various postoperative things were monitored for analysis, such as total opioid consumption, complications, and estimated blood loss.ResultsBoth the ketorolac and parecoxib groups showed significantly better early postoperative pain reduction at the postanesthesia care unit (PACU) than the control group (p < 0.05). There were no differences between the pain scores of ketorolac and parecoxib at any time points. Complications and bleeding were not significantly different between all three groups.ConclusionsPreemptive analgesia using both ketorolac and parecoxib showed a significantly better early postoperative pain control in the PACU than the control group in patients undergoing lumbar spinal fusion.Trial registrationClinicalTrials.gov NCT01859585. Registered 15 May 2013.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparing parecoxib and ketorolac as preemptive analgesia in patients undergoing posterior lumbar spinal fusion: a prospective randomized double-blinded placebo-controlled trial

Siribumrungwong

Cheewakidakarn

Tangtrakulwanich

et al. 2015

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Three studies (15,16,19) (n=868) provided specific data for analysis of PGESM at 48 h after surgery. We selected the fixed-effect model to perform the meta-analysis since there were no significant heterogeneities (effective, χ 2 =1.73, P=0.42, I2= 0%; ineffective χ 2 = 0.47, P= 0.79, I 2 = 0%).…”

Section: Resultsmentioning

confidence: 99%

“…Two (15,18) (n=454), two (14,18) (n=437) and four studies (14–16,19) (n=1171) provided data of respiratory depression, pruritus and headache, respectively. The incidence of respiratory depression, pruritus and headache between the treatment and control groups was not significantly different [RR= 0.84, 95% CI (0.38–1.83), P=0.66; RR=0.91, 95% CI (0.54–1.52), P=0.71; and RR=0.77, 95% CI (0.47–1.28), P=0.32, respectively; Fig.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of parecoxib sodium for acute postoperative pain: A meta-analysis

Wei

Zhao

2013

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

This meta-analysis was performed to evaluate the efficacy and safety of parecoxib sodium for acute postoperative pain. PubMed, Cochrane Central Register of Controlled Trials, EBSCO, Springer, Ovid and Chinese National Knowledge Infrastructure (CNKI) databases were searched from January 1999 to January 2013 to comprehensively collect randomized controlled trials (RCTs) of parecoxib sodium for acute postoperative pain. The methodological quality of the included RCTs were assessed and the data were extracted by two reviewers independently according to the Cochrane Handbook. Efficacies and safety (respiratory depression, pruritus, fever, headache, and nausea and vomiting) were pooled using meta-analysis performed by Review Manager 5.1 software. Relative risk (RR) and 95% confidence interval (CI) were calculated in a fixed-effects model. Seven RCTs involving 1,939 patients met the inclusion criteria. The results of the meta-analysis revealed that the rate of ‘effective’ treatment as described by the patients’ global evaluation of study medication (PGESM) was higher in the patient-controlled analgesia (PCA) combined with parecoxib sodium group 24, 48, and 72 h after the initial intravenous dose of 40 mg parecoxib compared with that in the control group [PCA alone; RR=1.41, 95% CI (1.13–1.75); RR=1.25, 95% CI (1.15–1.35); and RR=1.30, 95% CI (1.21–1.40), respectively]. The rate of ‘ineffective’ treatment in the PCA combined with parecoxib sodium group was lower compared with that of the control group [RR=0.43, 95% CI (0.26–0.72); RR= 0.44, 95% CI (0.34–0.57); and RR= 0.33, 95% CI (0.23–0.48), respectively]. Combination of PCA with parecoxib sodium reduced the incidence of postoperative fever [RR=0.34, 95% CI (0.22–0.53)], as well as nausea and vomiting [RR=0.69, 95% CI (0.57–0.83)]; however, it did not significantly reduce respiratory depression [RR= 0.84, 95% CI (0.38–1.83)], pruritus [RR= 0.91, 95% CI (0.54–1.52)] or headache [RR=0.77, 95% CI (0.47–1.28)]. The combination of PCA with parecoxib sodium successively injected for <3 days significantly increases the scores of PGESM and reduces the incidence of adverse effects and postoperative complications.

show abstract

“…The use of MMA regimens after joint arthroplasty has gained acceptance [29,30], but its use in the field of spine surgery is limited. A growing body of evidence supports the use of multimodal analgesia for spine surgery [4,9,31,32]. Several investigations have been conducted regarding the use of MMA as compared with the conventional pain control methods.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Analgesia (MMA) Versus Patient-Controlled Analgesia (PCA) for One or Two-Level Posterior Lumbar Fusion Surgery

Choi

Cho

Park

et al. 2020

JCM

View full text Add to dashboard Cite

A multimodal analgesic method was known to avoid the high-dose requirements and dose-dependent adverse events of opioids, and to achieve synergistic effects. The purpose of this study was to compare the efficacy of our multimodal analgesia (MMA) regimen with that of the patient-controlled analgesia (PCA) method for acute postoperative pain management. Patients who underwent one or two-level posterior lumbar fusion (PLF) followed by either MMA or PCA administration at our hospital were compared for pain score, additional opioid and non-opioid consumption, side effects, length of hospital stay, cost of pain control, and patient satisfaction. From 2016 through 2017, a total 146 of patients were screened. After propensity score matching, 66 remained in the PCA and 34 in the MMA group. Compared with the PCA group, the MMA group had a shorter length of hospital stay (median (interquartile range): 7 days (5–8) vs. 8 (7–11); P = 0.001) and lower cost of pain control (70.6 ± 0.9 USD vs. 173.4 ± 3.3, P < 0.001). Baseline data, clinical characteristics, pain score, additional non-opioid consumption, side effects, and patient subjective satisfaction score were similar between the two groups. The MMA seems to be a good alternative to the PCA after one or two-level PLF.

show abstract

Effect of Parecoxib on Postoperative Pain After Lumbar Spine Surgery

Cited by 60 publications

References 49 publications

Comparing parecoxib and ketorolac as preemptive analgesia in patients undergoing posterior lumbar spinal fusion: a prospective randomized double-blinded placebo-controlled trial

Comparing parecoxib and ketorolac as preemptive analgesia in patients undergoing posterior lumbar spinal fusion: a prospective randomized double-blinded placebo-controlled trial

Efficacy and safety of parecoxib sodium for acute postoperative pain: A meta-analysis

Multimodal Analgesia (MMA) Versus Patient-Controlled Analgesia (PCA) for One or Two-Level Posterior Lumbar Fusion Surgery

Contact Info

Product

Resources

About