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document
Effects of parecoxib on morphine analgesia after gynecology tumor operation : a randomized trial of parecoxib used in postsurgical pain management . BACKGROUND The analgesic efficacy of parecoxib in postsurgical pain management has been confirmed in minimally invasive surgery . However , little is known about its effects used in combination with opioids and about its potential for opioid-sparing effects in complex operations . This study was performed to investigate the influence of parecoxib on morphine analgesia after gynecological tumor surgery . METHODS Eighty patients undergoing gynecological tumor resection were randomized to receive either intravenous parecoxib at a dose of 40 mg ( Group P , n = 40 ) followed by 40 mg every 12 h for 48 h or saline as a control ( Group C , n = 40 ) 30 min before induction of anesthesia , followed by saline at the same time points after the operation . All patients had access to patient-controlled analgesia with intravenous morphine . Patients were assessed with respect to pain score ( visual analog scale from 0-10 ) , cumulative morphine requirement , satisfaction score , and side effects at 2 , 6 , 12 , 24 , and 48 h after surgery . RESULTS A total of 79 patients were evaluated . The cumulative dose of morphine administered at each time point was lower in Group P than in Group C ( P < 0.05 ) , at 2 h ( 3.81 ± 0.35 versus 4.13 ± 0.45 ; P = 0.01 ) , 6 h ( 16.20 ± 1.49 versus 19.60 ± 0.35 ; P < 0.001 ) , 12 h ( 26.29 ± 2.75 versus 32.49 ± 2.42 ; P < 0.001 ) , 24 h ( 41.72 ± 2.70 versus 49.97 ± 4.53 ; P < 0.001 ) , and 48 h ( 60.06 ± 4.00 versus 65.68 ± 3.23 ; P < 0.001 ) . Compared with Group C , Group P had significantly lower visual analog scale scores at rest and with movement , respectively , at 2 h ( 4.2 , P < 0.001 and 5.0 , P < 0.001 ) , 6 h ( 3.6 , P < 0.001 and 4.5 , P < 0.001 ) , 12 h ( 3.0 , P = 0.017 and 4.0 , P < 0.001 ) , 24 h ( 2.1 , P < 0.001 and 3.4 , P < 0.001 ) , and 48 h ( 1.8 , P < 0.001 and 2.6 , P < 0.001 ) . The satisfaction score was higher in Group P than in Group C ( 8.6 ± 0.3 versus 6.8 ± 0.7 , P < 0.001 ) . There were no significant differences in side effects between the two groups ( P > 0.05 ) . CONCLUSIONS The use of parecoxib with patient-controlled analgesic morphine in postoperative analgesia resulted in comprehensive enhancement of the analgesic efficacy , reducing the opioid requirement and increasing patient satisfaction after gynecological tumor surgery .
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Intervention_Pharmacological
parecoxib
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Intervention_Pharmacological
parecoxib
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Intervention_Pharmacological
parecoxib
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Intervention_Pharmacological
parecoxib on morphine
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Outcome_Pain
pain score ( visual analog scale from 0-10 )
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Outcome_Other
cumulative morphine requirement
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Outcome_Other
satisfaction score
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Outcome_Adverse-effects
side effects
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Outcome_Other
cumulative dose of morphine