Effects of preemptive analgesia with celecoxib or acetaminophen on postoperative pain relief following lower extremity orthopedic surgery

Kashefi, Parviz; Honarmand, Azim; Safavi, Mohammadreza

doi:10.4103/2277-9175.100197

Cited by 35 publications

(16 citation statements)

References 18 publications

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“…In orthopedic surgeries, NSAIDs have been widely used to reduce postoperative pain. Kashefi et al [23] reported that preoperative oral celecoxib at the dose of 200 mg every 2 h could effectively control the postoperative pain in patients who underwent lower extremity orthopedic surgeries. Compared with celecoxib and placebo, etoricoxib was more effective for PA in controlling postoperative pain [24].…”

Section: Nsaidsmentioning

confidence: 99%

The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review

Xu¹,

Zheng³

et al. 2019

Arthroplasty

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Total knee arthroplasty (TKA) is considered a cost-effective and efficacious treatment for patients with end-stage knee arthritis. Meanwhile, TKA has been regarded as one of the most painful orthopaedic surgeries. Pain control after TKA remains a challenging task. Many analgesic innovations are used to reduce the level of pain, but none has been proven to be the optimum choice till now. Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. This approach is a preferable choice in relieving postoperative pain with minimum side effects. This paper aims to review pre-emptive analgesia for pain management in TKA. We reviewed the application of pre-emptive analgesia, its physiological mechanism, and the techniques.

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Section: Nsaidsmentioning

confidence: 99%

The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review

Xu¹,

Zheng³

et al. 2019

Arthroplasty

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“…When comparing the use of acetaminophen with celecoxib for preemptive analgesia, celecoxib was superior to acetaminophen for reducing postoperative pain in patients undergoing lower extremity orthopedic surgery (28). …”

Section: Discussionmentioning

confidence: 99%

Multi-Modal Preemptive Analgesia With Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan in Radical Neck Dissection Surgery: A Randomized Clinical Trial

et al. 2016

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BackgroundPreemptive analgesia may be considered as a method not only to alleviate postoperative pain but also to decrease analgesic consumption. Different regimens are suggested, but there is currently no standard.ObjectivesThe aim was to measure the efficacy of preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery for reducing the intensity of pain and morphine consumption.Patients and MethodsThis study was conducted as a randomized double-blind clinical trial. Eighty adult patients (18 to 60 years of age) under the American society of anesthesiologists (ASA) physical status I and II undergoing elective radical neck dissection were enrolled. Patients were randomized into two groups of 40 with a simple randomization method. The case group received a combination of 15 mg/kg acetaminophen, 2.5 mg/kg pregabalin, 7 mg/kg naproxen, and 0.3 mg/kg dextromethorphan administered orally one hour prior to surgery. Postoperative pain was assessed with the universal pain assessment tool (UPAT) at 0, 2, 4, 6, 12, and 24 hours after surgery. Subjects received morphine based on postoperative pain control protocol. Total administered morphine doses were noted.ResultsPostoperative pain rates at 0, 2, 4, 6, 12, and 24 hours after surgery were significantly lower for the case group than the control group (P values = 0.014, 0.003, 0.00, 0.00, and 0.00, respectively). Total morphine doses for the preemptive analgesia group were 45% lower than those of the other group. Side effects were similar for both groups.ConclusionsA single preoperative oral dose of pregabalin, acetaminophen, dextromethorphan, and naproxen one hour before surgery is an effective method for reducing postoperative pain and morphine consumption in patients undergoing radical neck dissection.

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“…In another article performed by Gunsen et al . [ 22 ] the efficacy of Paracetamol versus Tenoxicam on postoperative pain, after abdominal hysterectomy, was evaluated, and it was found that Tenoxicam was associated with lower pain scores at the second, fourth, sixth, and twenty-fourth hour postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Comparison between paracetamol, piroxicam, their combination, and placebo in postoperative pain management of upper limb orthopedic surgery (a randomized double blind clinical trial)

2016

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Background:Therapeutic superiority of a combination of Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) over either drug alone remains controversial. We evaluated the efficiency of a combination of Paracetamol and Piroxicam versus each drug alone and also placebo in the management of postoperative pain, in patients who had undergone elective upper limb orthopedic surgery under general anesthesia.Materials and Methods:A total of 100 patients were randomly divided into four groups to receive either intravenous (IV) infusion of Paracetamol, 15 mg/kg., intramuscular (IM) injection of Piroxicam 0.4 mg/kg., their combination or placebo. The pain scores were recorded at the first; second, fourth, sixth, twelfth, and 24 hours after Post Anesthesia Care Unit (PACU) admission. After the operation 0.1 mg/kg of morphine was administered, if the patient needed.Result:The means of the pain scores were 5.26 ± 1.53, 4.09 ± 0.88, 4.36 ± 1.48, and 4.11 ± 1.29, in groups A, B, C, and D, respectively, (Group A: received placebo; Group B: received both Paracetamol and Piroxicam; Group C received Piroxicam; Group D received Paracetamol). Except for differences between the mean pain scores in Groups B and D, the other differences were statistically significant (P value < 0.05). No adverse effect was reported in the four groups.Conclusion:IV infusion of 15 mg/kg Paracetamol used as a preventive may provide effective analgesia in comparison with IM 0.4 mg/kg Piroxicam or placebo. Addition of Piroxicam to Paracetamol has not much more benefit than Paracetamol alone, in reducing pain after upper limb orthopedic surgery.

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Effects of preemptive analgesia with celecoxib or acetaminophen on postoperative pain relief following lower extremity orthopedic surgery

Cited by 35 publications

References 18 publications

The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review

The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review

Multi-Modal Preemptive Analgesia With Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan in Radical Neck Dissection Surgery: A Randomized Clinical Trial

Comparison between paracetamol, piroxicam, their combination, and placebo in postoperative pain management of upper limb orthopedic surgery (a randomized double blind clinical trial)

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