Pain Control in Laparoscopic Gynecologic Surgery with/without Preoperative (Preemptive) Parecoxib Sodium Injection: A Randomized Study
Sarwinee Ratchanon MD*, Chadakarn Phaloprakarn MD*, Khanitta Traipak MSN*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis, Bangkok, Thailand
Objective : To determine the effectiveness of preoperative parecoxib sodium injection for pain relief after laparoscopic
gynecologic surgery.
Material and Method: A prospective double-blind, randomized study was conducted in 268 patients who underwent
laparoscopic gynecologic surgery at Vajira Hospital between November 1, 2010 and March 31, 2011. The patients were
randomly allocated into two groups to receive either single intravenous 40 mg parecoxib (treatment group; n = 133) or
normal saline (control group; n = 135) 30 min before surgery. The degree of postoperative pain was assessed every 2 h in
the first 8 h postoperation, then every 4 h until completion of 24 h by using a verbal rating scale. Total consumption of
meperidine over a 24-h period and the adverse events relevant to parecoxib sodium were also recorded.
Results : Mean pain scores at all measured times in the treatment group were insignificantly lower than those in the control
group (p = 0.106). The mean 24-h postoperative meperidine consumption in the treatment group was significantly lower
compared to that in the control group (26.3 + 28.1 mg and 39.1 + 34.6 mg, respectively, p = 0.001). The proportion of patients
requiring meperidine in the treatment group was significantly lower than that in the control group (58.6% and 70.3%,
respectively, p = 0.045). No serious adverse events were observed in both groups.
Conclusion : Preoperative parecoxib sodium significantly reduced postoperative meperidine requirement and consumption,
while insignificantly declined the pain scores. Serious adverse events were not encountered.
Keywords : Preemptive analgesia, Parecoxib sodium, Laparoscopic gynecologic surgery
