Effect of preoperative administration of celecoxib on postoperative pain after laparoscopic cholecystectomy

Abstract

Background: For laparoscopic cholecystectomy, pain is most frequent complaint and the most common cause of delayed discharge. The aim of this study was to determine the effect of preoperative administration of celecoxib on the level of postoperative pain in patient undergoing laparoscopic cholecystectomy.Methods: We enrolled 60 patients ASA class I and II, scheduled for elective laparoscopic cholecystectomy. The patients were randomized to receive celecoxib 200 mg, celecoxib 400 mg or placebo two hour before the induction of anesthesia. The patients received the same anesthetics. The intensities of abdominal pain were assessed using VAS (visual analog scale) at 1, 2, 4, 12, 24 hours after surgery.Results: In celecoxib 200 mg group, VAS score of somatic pain compared to control group decreased at 1, 2, and 4 hours after surgery. In celecoxib 400 mg group, VAS score of somatic pain compared to control group decreased at 1, 2, and 4 hours after surgery. There was no difference between celecoxib 200 mg and celecoxib 400 mg in pain scores of somatic pain. Dosage of meperidine in two celecoxib groups after surgery were each 31 mg and 26 mg and that of control group was 72 mg. There was no difference between celecoxib groups and placebo group in pain scores of visceral pain.Conclusions: The preoperative administration of celecoxib reduces the level of postoperative pain after laparoscopic cholecystectomy without adverse effects.

Efficacy of early intravenous bolus oxycodone or fentanyl in emergence from general anaesthesia and postoperative analgesia following laparoscopic cholecystectomy: A randomized trial

“…32 Prostaglandin synthesis inhibitors, such as diclofenac and cyclo-oxygenase-2-selective nonsteroidal anti-inflammatory drugs, reduce postoperative pain following laparoscopic cholecystectomy, but do not sufficiently control pain. 25…”

“…Opioid drugs are useful in relieving postoperative pain, but are associated with a high risk of side-effects. 17,20 Nonopioid alternatives include lidocaine, magnesium, 24 diclofenac and celecoxib, 25 all of which have been used to treat postoperative pain following laparoscopic cholecystectomy. Lidocaine can be administered during the perioperative period to control central hyperalgesia, and affects mechanoinsensitive nociceptors, provides anti-inFammatory effects to sodium channel blockade [26][27][28] and inhibits N-methyl-D-aspartate (NMDA) receptors.…”

“…32 Prostaglandin synthesis inhibitors, such as diclofenac and cyclo-oxygenase-2selective nonsteroidal anti-inflammatory drugs, reduce postoperative pain following laparoscopic cholecystectomy, but do not sufficiently control pain. 25 Oxycodone is an opioid agonist, and is superior to other opioids for treating visceral pain. 33 Oxycodone has affinity for k, , and Á receptors within the central, peripheral and autonomous nervous systems, inhibits adenylylcyclase, hyperpolarizes nerve cells, and reduces excitability.…”

Risks of serious adverse events with non‐steroidal anti‐inflammatory drugs in gastrointestinal surgery: A systematic review with meta‐analysis and trial sequential analysis

“…Of the included trials, 89 did not mention SAEs, 28–116 and two trials mentioned potential SAEs without specifying in which intervention group these events occurred 117,118 . Lack of response to email inquiries meant these studies could not provide relevant or quantifiable data for any of our outcomes.…”