Canadian Journal of Anesthesia

, Volume 54, Issue 5, pp 342–348

Effect of short-term postoperative celecoxib administration on patient outcome after outpatient laparoscopic surgery

  • Paul F. White
  • Ozlem Sacan
  • Burcu Tufanogullari
  • Matthew Eng
  • Nina Nuangchamnong
  • Babatunde Ogunnaike
Reports of Original Investigation

Abstract

Purpose

Non-opioid analgesics are increasingly used as part of a multimodal regimen for pain management. This prospective, randomized, double-blinded, placebo-controlled study was designed to evaluate the effect of short-term postoperative administration of celecoxib on pain management and recovery outcomes following laparoscopic surgery.

Methods

Eighty consenting ASA I-III outpatients undergoing laparoscopic surgery were randomly assigned to one of two treatment groups: Control (placebo) or Celecoxib (celecoxib, 400 mg·day-1). The initial dose (celecoxib 400 mg or placebopo) was administered in the recovery room, and celecoxib 200 mg (or a placebo)po bid was continued for three additional days after surgery. Postoperative pain scores and the need for opi-oid-containing analgesics were recorded at specific intervals in the recovery room. Follow-up evaluations were performed at 24 hr, 48 hr, 72 hr and seven days and one month after surgery to assess post-discharge pain, analgesic requirements, complications, quality of recovery, and resumption of normal activities, as well as patient satisfaction with their pain management.

Results

Celecoxib reduced mean pain scores and the need for analgesics at 24 hr and 48 hr postoperatively. Patient satisfaction with their postoperative pain management was also higher in the Celecoxib group (94 ± 8 vs 80 ± 25,P < 0.05). Quality of recovery scores were significantly higher in the Celecoxib group on the first and second postoperative days (17 ± 1 vs 15 ± 2, and 18 ± 1 vs 16 ± 2, respectively). Finally, bowel function recovered an average of one day earlier and patients resumed activities of daily living two days earlier in the Celecoxib group (P < 0.05).

Conclusion

Short-term administration of celecoxib, 400 mg·day−1po, decreased postoperative pain and the need for opioid-containing analgesic medication, leading to an improved quality of recovery after outpatient laparoscopic surgery.

Effet de l’ administration postopératoire à court terme de célécoxib sur l’évolution des patients après une chirurgie par laparoscopie sans hospitalisation

Résumé

Objectif

Les analgésiques non-opiacés sont de plus en plus utilisés dans le cadre d’un régime multimodal pour le traitement de la douleur. Cette étude prospective, randomisée, à double insu et contrôlée par placebo a été effectuée afin de déterminer l’effet de l’administration postopératoire à court terme de célécoxib sur le traitement de la douleur et la convalescence suite à une chirurgie laparoscopique.

Méthode

Quatre-vingt patients ASA I-III non hospitalisés subissant une chirurgie laparoscopique ont été randomisés en deux groupes de traitement : Témoin (placebo) ou Célécoxib (célécoxib, 400 mg·jour−1). La dose initiale (célécoxib 400 mg ou placebo po) a été administrée à la salle de réveil, et l’administration de célécoxib 200 mg (ou un placebo) po a été continuée deux fois par jour pendant trois jours suivant l’opération. La douleur postopératoire et les besoins en analgésiques à base d’opiacés ont été mesurés à des intervalles spécifiques à la salle de réveil. Des examens de contrôle ont été effectués 24 h, 48 h, 72 h, sept jours et un mois après la chirurgie afin d’évaluer la douleur suite au congé de l’hôpital, les besoins analgésiques, les complications, la qualité du rétablissement et la reprise des activités normales, ainsi que la satisfaction des patients quant au traitement de la douleur.

Résultats

Le célécoxib a réduit les scores moyens de douleur ainsi que le besoin d’analgésiques à 24h et 48h après l’opération. La satisfaction des patients quant au traitement postopératoire de la douleur qu’ils ont reçu était également plus élevée dans le groupe célécoxib (94 ±8 vs 80 ± 25,P< 0,05). Les résultats de la qualité du rétablissement étaient significativement plus élevés dans le groupe célécoxib le premier et le deuxième jour après l’opération (17±1vs15±2,et18 ± 1 vs 16 ± 2, respectivement). Finalement, la fonction intestinale a été rétablie en moyenne un jour plus tôt et les patients ont repris leurs activités quotidiennes deux jours plus tôt dans le groupe célécoxib (P < 0,05).

Conclusion

L’administration à court terme de célécoxib 400 mg·jour−1 po a diminué la douleur postopératoire et le besoin de médication analgésique à base d’opiacés, ce qui a engendré une qualité de rétablissement améliorée après la chirurgie laparoscopi-que sans hospitalisation.

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Copyright information

© Canadian Anesthesiologists 2007

Authors and Affiliations

  • Paul F. White
    • 1
  • Ozlem Sacan
    • 1
  • Burcu Tufanogullari
    • 1
  • Matthew Eng
    • 1
  • Nina Nuangchamnong
    • 1
  • Babatunde Ogunnaike
    • 1
  1. 1.Department of Anesthesiology and Pain ManagementUniversity of Texas Southwestern Medical Center at DallasDallasUSA

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