Preventive effects of perioperative parecoxib on post-discectomy pain
| Autor: | P.D. Klassen, S. Dreyer, J. Peters, M. Weiss, Matthias Eikermann, A. Bello, G. Riest, B. Stegen |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Analgesic Placebo Preoperative care Drug Administration Schedule Perioperative Care Double-Blind Method Parecoxib Discectomy medicine Humans Cyclooxygenase Inhibitors Prospective Studies Aged Pain Measurement Aged 80 and over Postoperative Care Pain Postoperative Morphine business.industry Isoxazoles Perioperative Analgesics Non-Narcotic Middle Aged Surgery Analgesics Opioid Intervertebral disk Anesthesiology and Pain Medicine Opioid Anesthesia business Preanesthetic Medication Diskectomy medicine.drug |
| Zdroj: | British Journal of Anaesthesia. 100:256-262 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aem345 |
| Popis: | Background Cyclooxygenase inhibitor treatment is viewed increasingly critical because of safety considerations, and there are several open questions on their optimal use. Methods In a randomized placebo-controlled study in 320 patients undergoing discectomy, we administered parecoxib 40 mg either perioperatively (before operation and after operation), after operation (first dose given in the evening after surgery), or before operation (single parecoxib dose given 45 min before surgery). We measured the main outcome variables: average pain score, morphine consumption, and opioid-related symptom distress at 25, 49, and 73 h after surgery. Results Perioperative parecoxib significantly (i) improved the pain score compared with both placebo and postoperative parecoxib, (ii) decreased morphine consumption, and (iii) reduced the opioid-related symptom distress score. Neither a single preoperative dose nor postoperative parecoxib (first dose given in the evening after surgery) significantly improved morphine's analgesic effectiveness. Conclusions Perioperative parecoxib compared with postoperative parecoxib improves post-discectomy pain and results in a reduction in adverse effects associated with opioid therapy. Postoperative parecoxib, or a single pre-incisional parecoxib dose, does not significantly improve post-discectomy pain or opioid side-effects up to 3 days after surgery. |
| Databáze: | OpenAIRE |
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