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Perioperative Schmerztherapie mit Rofecoxib

Wie wirksam ist die präoperative Gabe einer 25-mg-Dosis bei muskuloskelettalen Operationen?

Postoperative analgesia with rofecoxib

How effective is the preoperative application of a 25 mg dose?

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Zusammenfassung

Fragestellung

Wie wirksam ist eine präoperative Gabe des Cyclooxygenase-2-Hemmers Rofecoxib in einer Dosis von 25 mg bei kleineren kniegelenknahen Operationen?

Methodik

31 Patienten erhielten 2 h präoperativ sowie nach 24 h jeweils 25 mg Rofecoxib oral (Verumgruppe), eine Kontrollgruppe von ebenfalls 31 Patienten ein gleichaussehendes Placebopräparat. Nach einer Operation an der unteren Extremität erhielten alle Patienten ein patientenkontrolliertes Analgesie-(PCA-)Gerät, mit dem sie sich intravenös Piritramid anfordern konnten. Sie waren angewiesen, sich auf ein gut erträgliches Schmerzniveau auf der numerischen Ratingskala (NRS) von 3 (0–10) zu titrieren. Erfasst wurden über 24 h der kumulative Piritramidverbrauch, die Schmerzscores der Patienten sowie Nebenwirkungen.

Ergebnisse

Beide Gruppen hatten zu allen Erhebungszeitpunkten vergleichbare Schmerzscores. Die Patienten der Verumgruppe forderten exakt die gleiche Menge Piritramid aus dem PCA-Gerät an wie die Patienten der Placebogruppe.

Schlussfolgerungen

Die präoperative Gabe von 25 mg Rofecoxib hat nach dem Ergebnis der vorliegenden Studie auch bei kleineren muskuloskelettalen Operationen keinen analgetischen Effekt.

Abstract

Objective

The purpose of this study was to evaluate the analgesic efficacy of 25 mg rofecoxib.

Methods

In a randomized, prospective double-blind study we investigated the analgesic efficacy of 25 mg rofecoxib in 62 patients scheduled for minor trauma surgery. Patients received 2 h before induction of anesthesia either 25 mg rofecoxib (verum) orally or placebo. These applications were repeated postoperatively after 24 h. Postoperative pain intensity was measured by the numeric rating scale (NRS). All patients were allowed to order piritramid from a PCA-device (bolus 2 mg, lockout 5 min in the recovery room, 15 min on the ward) for 24 h after surgery. 10/20/30 min, as well as 1/2/4/6 h and 24 h after surgery cumulated doses of piritramid, pain scores (0–10) and side effects were recorded.

Results

Pain relief and cumulated doses of piritramid in both groups were comparable at all points in time. There were no significant differences in the incidence of side effects between the two groups.

Conclusion

Preoperative application of 25 mg rofecoxib is not effective for postoperative analgesia in patients after minor trauma surgery.

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Authors and Affiliations

  1. Schmerzambulanz, Universitätsklinik für Anästhesiologie Ulm

    P. Steffen & W. Seeling

  2. Abteilung für Anästhesie, Intensiv- und Schmerztherapie des Krankenhauses Wangen, Oberschwaben-Klinik GmbH Ravensburg

    M. Krell

  3. Schmerzambulanz, Universitätsklinik für Anästhesiologie, Steinhövelstr. 9, 89075 , Ulm

    P. Steffen

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  1. P. Steffen
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Correspondence to P. Steffen.

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Steffen, P., Krell, M. & Seeling, W. Perioperative Schmerztherapie mit Rofecoxib. Schmerz 18, 278–285 (2004). https://doi.org/10.1007/s00482-003-0304-0

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