Efficacy of Perioperative Administration of Intravenous
Parecoxib on Postoperative Morphine Consumption after
Video-Assisted Thoracoscopic Surgery
Sarinya Chanthawong MD¹, Jinaree Promprasert MD¹, Netinai Chaimala RN¹, Pathawat Plengpanich MD¹,
Saranyoo Nonphiaraj MD¹
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
Background: Morphine is commonly used to relief pain after video-assisted thoracoscopic surgery (VATS), however high dose morphine is
usually related with many complications. Parecoxib is a potent cyclo-oxygenase inhibitor for parenteral administration that has a role in acute
pain management addition to opioid protocol.
Objective: To investigate the potential benefits of intravenous parecoxib for relieving postoperative pain after VATS.
Materials and Methods: The present study was a randomized controlled trial that assigned 22 patients undergoing VATS into two groups to received either parecoxib 40 mg as P group with 11 patients, or placebo using 2 mL of Normal Saline Solution as C group with 11 patients with an intravenous administration at 30 minutes prior to surgery and then 12 hours later. In the postoperative period, all patients received intravenous patient-controlled analgesia (PCA) with morphine. The primary outcome was the total morphine consumption for 24 hours postoperatively. The secondary outcomes were pain score at 2, 6, 12, and 24 hours postoperatively, using a numeric rating scale (NRS, 0 to 10) and the incidence of side effects.
Results: The total morphine consumption was significantly lower in P group (26.64±4.41 mg) than C group (39.82±3.87 mg) at 24 hours postoperatively (p<0.001). The NRS pain score at rest and on coughing at 24 hours postoperatively between P group compared with C group were 1.09±1.04 versus 4.45±0.69 (p<0.001) and 2.91±0.83 versus 5.36±0.81 (p<0.001), respectively. The incidences of nausea and vomiting were found in both groups at 2, 6, and 12 hours, postoperatively, but there was no statistically significant difference between both groups (p>0.05). Other adverse events such as sedation, pruritus, dyspepsia, headache, hypotension, and respiratory depression were not found.
Conclusion: Perioperative administration of parecoxib was safe and effectively decrease postoperative morphine consumption and pain score at rest and on coughing within 24 hours postoperatively after VATS.
Received 5 July 2021 | Revised 21 September 2021 | Accepted 21 September 2021
doi.org/10.35755/jmedassocthai.2021.11.13131
Keywords :
Intravenous parecoxib; Video-assisted thoracoscopic surgery; Acute postoperative pain
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