Efficacy of a single 40‐mg intravenous dose of parecoxib for postoperative pain control after elective cesarean delivery: A double‐blind randomized placebo‐controlled trial

Inthigood, Nittaya; Lertbunnaphong, Tripop; Jaishuen, Atthapon

doi:10.1111/jog.13187

Cited by 13 publications

(19 citation statements)

References 31 publications

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“…Parecoxib is another intravenous NSAID that has been approved in European and Asian countries and in Mexico. A single dose of intravenous parecoxib did not reduce postoperative morphine consumption, but it reduced postoperative pain scores with higher patient satisfaction [ 94 ]. With respect to NSAIDs in oral or suppository form, naproxen [ 95 ], ibuprofen [ 96 ], celecoxib [ 97 ], and diclofenac suppositories [ 98 , 99 ] are mostly effective compared with placebo ( Table 3 ).…”

Section: Special Concerns About Pain Control In Cesarean Deliverymentioning

confidence: 99%

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Sangkum

Thamjamrassri

Arnuntasupakul

et al. 2021

Anesthesiology Research and Practice

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Optimal postoperative analgesia has a significant impact on patient recovery and outcomes after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery and pain management. For a standard analgesic regimen, the use of long-acting neuraxial opioids (e.g., morphine) and adjunct drugs, such as scheduled acetaminophen and nonsteroidal anti-inflammatory drugs, is recommended unless contraindicated. Oral or intravenous opioids should be reserved for breakthrough pain. In addition to the aforementioned use of multimodal analgesia, preoperative evaluation is critical to individualize the analgesic regimen according to the patient requirements. Risk factors for severe postoperative pain or analgesia-related adverse effects will require modifications to the standard analgesic regimen (e.g., the use of ketamine, gabapentinoids, or regional anesthetic techniques). Further investigation is required to determine analgesic drugs or dose alterations based on preoperative predictions for patients at risk of severe pain. Outcomes beyond pain and analgesic use, such as functional recovery, should be determined to evaluate analgesic treatment protocols.

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Section: Special Concerns About Pain Control In Cesarean Deliverymentioning

confidence: 99%

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Sangkum

Thamjamrassri

Arnuntasupakul

et al. 2021

Anesthesiology Research and Practice

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“…Akan tetapi, pemberian parecoxib 40 mg intravena pada penelitian tersebut menunjukkan efektivitasnya dalam mengurangi skor nyeri yang mengantarkan pada kepuasan pasien. 22…”

Section: Ketorolakunclassified

“…23 Sebuah ulasan sistematik dengan meta-analisis dan analisis penelitian sekuensial menyimpulkan bahwa deksametason intravena meningkatkan analgesia pascabedah setelah anestesi spinal dengan mengurangi konsumsi ekuivalen morfin 24 jam dan dengan memperpanjang waktu yang dibutuhkan hingga permintaan obat analgesia. 22 Pada meta-analisis yang meliputi penelitian-penelitian pada pasien yang menjalani berbagai prosedur pembedahan, deksametason perioperatif dosis tunggal tidak mengganggu penyembuhan luka maupun meningkatkan risiko infeksi. Penambahan dosis tunggal deksametason prabedah meningkatkan analgesia pasca pembedahan dan mengurangi insidens PONV.…”

Section: Deksametasonunclassified

Manajemen Nyeri Terkini pada Pasien Pasca Seksio Sesarea

Ahmad

Taufik

2021

JAOI

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Prosedur Seksio Sesarea (SS) seringkali menyebabkan nyeri sedang hingga berat selama 48 jam. Tujuan manajemen nyeri pascabedah adalah untuk memberikan kenyamanan pada pasien, menghambat impuls nosiseptif, dan menumpulkan respon neuroendokrin terhadap nyeri, yang dengan demikian mempercepat kembalinya fungsi fisiologis. Selain itu, manajemen nyeri yang adekuat pada pasien SS memungkinkan mobilisasi dini untuk mencegah risiko tromboemboli yang meningkat selama kehamilan dan pasien perlu bebas nyeri untuk merawat bayi serta memberikan ASI secara efektif. Mekanisme nyeri pascabedah terdiri dari sensitisasi perifer dan senstisasi sentral dari susunan saraf. Dampak klinik sensitisasi sistem saraf berupa hiperalgesia dan alodinia. Sensitisasi pascabedah akan mengakibatkan penderitaan bagi pasien sehingga pada akhirnya dapat meningkatkan angka morbiditas dan mortalitas pascabedah, oleh karena itu manajemen nyeri pascabedah harus ditujukan ke arah pencegahan dan meminimalkan terjadinya proses sensitisasi. Analgesia multimodal dengan mengkombinasi obat yang menghambat sensitisasi perifer dan sentral, dengan opioid sebagai analgesia penyelamat dapat menjadi pilihan untuk memberikan manajemen nyeri yang adekuat dan meminimalkan efek samping. Current Practice for Post Operative Pain Management in Caesarean Section Abstract Caesarean section (CS) is frequently followed by moderate to severe pain up to 48 hours after surgery. Postoperative pain management is aimed to provide postoperative comfortness, inhibits nociceptive impulse, and blunts neuroendocrine response to pain, thus enhance the return of physiological function. Moreover, an adequate pain management in CS patients allows early mobilization in preventing the increased of thromboemboli risk during pregnancy, the need of patients to be pain free in taking care of the baby as well as effective breastfeeding. Postoperative pain mechanism consists of peripheral and central senzitisation of nervous system. Clinical impact of nervous system sensitization including hyperalgesia and allodynia. Postoperative sensitization resulted in patient’s suffering that increase morbidity and mortality rate eventually. Therefore, postoperative pain management should be directed to prevent and minimalize sensitization process. Multimodal analgesia by combining analgesics inhibited peripheral and central sensitization, with opioid as rescue analgesic may be preferred to provide adequate pain management and to minimalize the adverse effects.

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“…Pain scores (Visual analogue scale, VAS; 0, no pain to 10, worst imaginable pain) were assessed post-operatively at 2, 4, 6, 8, 10, 12 and 24 h (18). When VAS was ≥4, 40 mg parecoxib sodium was administered intravenously as a rescue analgesic (19). The number of patients who required rescue analgesic and time to first request were also recorded.…”

Section: Patientsmentioning

confidence: 99%

Ultrasound‑guided transversus abdominis plane block using ropivacaine and dexmedetomidine in patients undergoing caesarian sections to relieve post‑operative analgesia: A randomized controlled clinical trial

et al. 2020

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Dexmedetomidine, which is a highly selective α2 adrenoreceptor agonist, enhances the analgesic efficacy and prolongs the analgesic duration when administered in combination with local anesthetics. The current study aimed to evaluate the effects of dexmedetomidine combined with ropivacaine in ultrasound-guided transversus abdominis plane (TAP) block on post-operative analgesia following cesarean section (CS). A total of 70 patients scheduled for CS were divided randomly into 2 groups: The ropivacaine (R) group, in which patients were administered bilateral 20 ml 0.3% ropivacaine and 2 ml 0.9% normal saline, and the dexmedetomidine (RD) group, in which patients were administered bilateral 20 ml 0.3% ropivacaine and 2 ml dexmedetomidine (0.5 µg/kg). The primary outcome was pain-free duration, and secondary outcomes included heart rate (HR) and mean blood pressure (MBP) measurements, visual analogue scale (VAS) pain scores, number of patients who required rescue analgesic, time to first request for analgesia and patient satisfaction. There was no significant difference in HR and MBP between the two groups at 1 h post-surgery (P>0.05). However, VAS pain scores decreased at 6 and 8 h post-surgery [2 (1-2) vs. 0 (0-0.25) and 2 (2-3) vs. 0 (0-1), respectively; P<0.05], pain-free duration was prolonged (5.91±1.08 vs. 9.62±1.46 h; P<0.05), the number of patients who required rescue analgesic was reduced (19 vs. 9; P<0.05), the time to first request for analgesia was prolonged (7.10±1.21 vs. 11.60±2.11 h; P<0.05) and patient satisfaction was improved [3.5 (3-4) vs. 4 (4-5); P<0.05] in the RD group compared with the R group. Furthermore, no bradycardia or hypotension was observed. In conclusion, the results of the present study demonstrated that adding 0.5 µg/kg dexmedetomidine to 0.3% ropivacaine used in TAP block in patients undergoing CS prolonged pain-free duration, decreased VAS pain scores, reduced the number of patients who required rescue analgesic, prolonged the time to first request for analgesia and improved the patient satisfaction without serious side effects.

show abstract

Efficacy of a single 40‐mg intravenous dose of parecoxib for postoperative pain control after elective cesarean delivery: A double‐blind randomized placebo‐controlled trial

Cited by 13 publications

References 31 publications

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Manajemen Nyeri Terkini pada Pasien Pasca Seksio Sesarea

Ultrasound‑guided transversus abdominis plane block using ropivacaine and dexmedetomidine in patients undergoing caesarian sections to relieve post‑operative analgesia: A randomized controlled clinical trial

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