Parecoxib Added to Ropivacaine Prolongs Duration of Axillary Brachial Plexus Blockade and Relieves Postoperative Pain

Abstract

Background Cyclooxygenase (COX)-2 antagonist is widely used for intravenous postoperative pain relief. Recent studies reported COX-2 in the spinal dorsal horn could modulate spinal nociceptive processes. Epidural parecoxib in rats showed no neurotoxicity. These findings suggested applying a COX-2 antagonist directly to the central or peripheral nerve might provide better analgesia. Questions/purposes We therefore determined: (1) whether the addition of parecoxib to ropivacaine injected locally on the nerve block affected the sensory and motor block times of the brachial plexus nerve block; and (2) whether parecoxib injected locally on the nerve or intravenously had a similar analgesic adjuvant effect.Methods We conducted a randomized controlled trial from January 2009 to November 2010 with 150 patients scheduled for elective forearm surgery, using a multiplenerve stimulation technique. Patients were randomly allocated into one of three groups: Group A (n = 50) received ropivacaine 0.25% alone on the brachial plexus nerve; Group B (n = 50) received ropivacaine together with 20 mg parecoxib locally on the nerve block; and Group C (n = 50) received 20 mg parecoxib intravenously. We recorded the duration of the sensory and motor blocks, and the most severe pain score during a 24-hour postoperative period.

Contribution of diacylglycerol lipase β to pain after surgery

“… 15 Morphine is the mainstay treatment for acute postsurgical pain, while COX inhibitors are often used as primary or adjunct analgesics. 2 , 8 , 17 , 29 , 31 However, perioperative administration of opioids can lead to respiratory depression, paralytic ileus, and increased risk of addiction, and in patients with a history of opioid use, further complications during recovery. 11 , 26 , 41 Similarly, use of COX inhibitors increases the risk of postoperative bleeding, most prominently in older patients and in those with cardiovascular disease.…”

The Use of NSAIDs in the Postoperative Period: Advantage and Disadvantages

“…have a huge application [16][17][18]. The aim of this review is to evaluate the effectiveness and the use of NSAIDs in the treatment of postoperative pain and to focus on mechanism of action of NSAID and on side effects, especially cardiovascular and renal function during postoperative acute administration.…”

The Study of Different Approaches of Parecoxib Sodium Pretreatment on the Behavior of Rats with Neuropathic Pain

“…If the test result was different from the last result, the same intensity of stimuli was applied continuously for four times. Rats were tested by 50 % PMWT for six times [11,12].…”