Presurgical intravenous parecoxib sodium and follow-up oral valdecoxib for pain management after laparoscopic cholecystectomy surgery reduces opioid requirements and opioid-related adverse effects
| Autor: | D. B. Hanna, S. Z. Zhao, Raymond Cheung, Connie Chen, Girish P. Joshi, Tong J. Gan |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Analgesic Administration Oral Placebo law.invention Double-Blind Method Randomized controlled trial Parecoxib law medicine Humans Cyclooxygenase Inhibitors Hydrocodone Adverse effect Aged Pain Measurement Pain Postoperative Sulfonamides Cyclooxygenase 2 Inhibitors business.industry Membrane Proteins Isoxazoles General Medicine Middle Aged Valdecoxib Acetaminophen Surgery Analgesics Opioid Isoenzymes Anesthesiology and Pain Medicine Cholecystectomy Laparoscopic Opioid Cyclooxygenase 2 Prostaglandin-Endoperoxide Synthases Anesthesia Injections Intravenous Female business medicine.drug |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 48:1194-1207 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/j.1399-6576.2004.00495.x |
| Popis: | Background: Opioids are associated with numerous adverse effects. It is unclear if reduced postoperative opioid consumption lowers the incidence and severity of opioid-related adverse effects. This analysis – from a multicenter, randomized, double-blind trial – tested if the reduction of opioid consumption among patients who received intravenous preoperative parecoxib 40 mg, followed by oral valdecoxib 40 mg qd postoperatively, in Days 1–4 after outpatient laparoscopic cholecystectomy surgery, reduced opioid-related symptoms. Methods: Patients received intravenous fentanyl for pain before discharge, and oral acetaminophen 500 mg hydrocodone 5 mg q 4–6 h prn postdischarge for up to 7 days postsurgery. Patients also received intravenous parecoxib 40 mg administered 30–45 min preoperatively, and valdecoxib 40 mg qd up to Day 4 and prn Days 5–7 postsurgery, or placebo. Patients completed an opioid-related Symptoms Distress Scale (SDS) questionnaire every 24 h for 7 days. Opioid use was converted to morphine-equivalent doses (MEDs). Clinically meaningful events (CMEs) for 12 opioid-related symptoms were assessed by three ordinal measures: frequency, severity, and bothersomeness. Reduction of CMEs on Day 1 and number of patient-days with CMEs on Days 1–4 were examined. Results: Cumulative MEDs on Day 0, Day 1, and Days 1–4 were significantly lower in the parecoxib/valdecoxib group compared with the placebo group (P |
| Databáze: | OpenAIRE |
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