Skip to main content
SpringerLink
Log in

Efficacy of celecoxib as preemptive analgesia for patients undergoing laparoscopic inguinal hernia repair: a randomized trial

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To investigate the efficacy and safety of preemptive analgesia with a transversus abdominis plane (TAP) block versus celecoxib for patients undergoing laparoscopic transabdominal preperitoneal inguinal hernia repair (LTAPP).

Methods

Sixty patients scheduled for LTAPP were randomized into three groups: a celecoxib group, given 200 mg celecoxib 2 h before surgery; a celecoxib/diclofenac group, given 200 mg celecoxib 2 h before surgery and 50 mg rectal diclofenac sodium on recovery from general anesthesia; and a block group, given a TAP block with 60 mL 0.25% levobupivacaine after general anesthesia. We assessed the numerical rating scale (NRS) scores for pain at rest and with movement 24 h after surgery. Postoperative analgesia use and adverse events were also evaluated.

Results

The NRS scores for pain at rest and with movement were lower in the celecoxib group than in the block group, 24 h postoperatively. The time to first request for analgesia tended to be longer in the block group than in the celecoxib group. No significant between-group differences were noted in analgesic use or adverse events.

Conclusions

Celecoxib was not inferior to the TAP block as preemptive analgesia. Thus, celecoxib could be given as simple preemptive analgesia for LTAPP by considering a multimodal analgesic strategy in the early postoperative period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gupta A, Kaur K, Sharma S, Goyal S, Arora S, Murthy RS. Clinical aspects of acute post-operative pain management and its assessment. J Adv Pharm Technol Res. 2010;1(2):97–108.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Curatolo M. Adding regional analgesia to general anaesthesia: increase of risk or improved outcome? Eur J Anaesthesiol. 2010;27(7):586–91.

    Article  Google Scholar 

  3. Reinpold W. Risk factors of chronic pain after inguinal hernia repair: a systematic review. Innovative surgical sciences. 2017;2(2):61–8.

    Article  Google Scholar 

  4. Weinbroum AA. Postoperative hyperalgesia—a clinically applicable narrative review. Pharmacol Res. 2017;120:188–205.

    Article  Google Scholar 

  5. Öberg S, Andresen K, Rosenberg J. Decreasing prevalence of chronic pain after laparoscopic groin hernia repair: a nationwide cross-sectional questionnaire study. Surg Today. 2018;48(8):796–803.

    Article  Google Scholar 

  6. Molegraaf M, Lange J, Wijsmuller A. Uniformity of chronic pain assessment after inguinal hernia repair: a critical review of the literature. Eur Surg Res Europaische Chirurgische Forschung Recherches Chirurgicales Europeennes. 2017;58(1–2):1–19.

    PubMed  Google Scholar 

  7. Jankovic Z, Ahmad N, Ravishankar N, Archer F. Transversus abdominis plane block: how safe is it? Anesth Analg. 2008;107(5):1758–9.

    Article  Google Scholar 

  8. Gurunathan U, Rapchuk IL, King G, Barnett AG, Fraser JF. The effect of pregabalin and celecoxib on the analgesic requirements after laparoscopic cholecystectomy: a randomized controlled trial. J Anesthesia. 2016;30(1):64–71.

    Article  Google Scholar 

  9. Phinchantra P, Bunyavehchevin S, Suwajanakorn S, Wisawasukmongchol W. The preemptive analgesic effect of celecoxib for day-case diagnostic laparoscopy. J Med Assoc Thailand: Chotmaihet thangphaet. 2004;87(3):283–8.

    Google Scholar 

  10. Manangi M, Shivashankar S, Vijayakumar A. Chronic pain after inguinal hernia repair. Int Scholar Res Not. 2014;2014:839681.

    Google Scholar 

  11. Chan FKL, Ching JYL, Tse YK, Lam K, Wong GLH, Ng SC, et al. Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding (CONCERN): an industry-independent, double-blind, double-dummy, randomised trial. Lancet (London, England). 2017;389(10087):2375–82.

    Article  CAS  Google Scholar 

  12. Masclee GM, Valkhoff VE, Coloma PM, de Ridder M, Romio S, Schuemie MJ, et al. Risk of upper gastrointestinal bleeding from different drug combinations. Gastroenterology. 2014;147(4):784-92.e9 ((quiz e13-4)).

    Article  CAS  Google Scholar 

  13. Sami Mebazaa M, Frikha N, Ben Hammouda N, Mestiri T, Mestiri H, Khalfallah T, et al. Postoperative analgesia after laparoscopic cholecystectomy: comparison of the preoperative administration of celecoxib with paracetamol? Tunis Med. 2008;86(10):869–73.

    PubMed  Google Scholar 

  14. White PF, Sacan O, Tufanogullari B, Eng M, Nuangchamnong N, Ogunnaike B. Effect of short-term postoperative celecoxib administration on patient outcome after outpatient laparoscopic surgery. Canadian J Anaesth: J Canadien d’Anesthesie. 2007;54(5):342–8.

    Article  Google Scholar 

  15. Owens WD. American society of anesthesiologists physical status classification system in not a risk classification system. Anesthesiology. 2001;94(2):378.

    Article  CAS  Google Scholar 

  16. Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: which to use? The Am J Emerg Med. 2018;36(4):707–14.

    Article  Google Scholar 

  17. Al-Sukhun J, Al-Sukhun S, Penttila H, Ashammakhi N, Al-Sukhun R. Preemptive analgesic effect of low doses of celecoxib is superior to low doses of traditional nonsteroidal anti-inflammatory drugs. J Craniofac Surg. 2012;23(2):526–9.

    Article  Google Scholar 

  18. Kashefi P, Honarmand A, Safavi M. Effects of preemptive analgesia with celecoxib or acetaminophen on postoperative pain relief following lower extremity orthopedic surgery. Adv Biomed Res. 2012;1:66.

    Article  Google Scholar 

  19. Alfieri S, Amid PK, Campanelli G, Izard G, Kehlet H, Wijsmuller AR, et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia. 2011;15(3):239–49.

    Article  CAS  Google Scholar 

  20. Pogatzki-Zahn EM, Segelcke D, Schug SA. Postoperative pain-from mechanisms to treatment. Pain reports. 2017;2(2):e588.

    Article  Google Scholar 

  21. Zhou F, Du Y, Huang W, Shan J, Xu G. The efficacy and safety of early initiation of preoperative analgesia with celecoxib in patients underwent arthroscopic knee surgery: a randomized, controlled study. Medicine. 2017;96(42):e8234.

    Article  CAS  Google Scholar 

  22. Beaussier M, Parc Y, Guechot J, Cachanado M, Rousseau A, Lescot T. Ropivacaine preperitoneal wound infusion for pain relief and prevention of incisional hyperalgesia after laparoscopic colorectal surgery: a randomized, triple-arm, double-blind controlled evaluation vs intravenous lidocaine infusion, the CATCH study. Colorectal Dis: The Off J Assoc Coloproctol G B and Irel. 2018;20(6):509–19.

    Article  CAS  Google Scholar 

  23. Bollag L, Richebe P, Siaulys M, Ortner CM, Gofeld M, Landau R. Effect of transversus abdominis plane block with and without clonidine on post-cesarean delivery wound hyperalgesia and pain. Reg Anesth Pain Med. 2012;37(5):508–14.

    Article  CAS  Google Scholar 

  24. Liu Z, Xu Y, Liu ZL, Tian YZ, Shen XH. Combined application of diclofenac and celecoxib with an opioid yields superior efficacy in metastatic bone cancer pain: a randomized controlled trial. Int J ClinOncol. 2017;22(5):980–5.

    CAS  Google Scholar 

  25. Mercadante S. The use of anti-inflammatory drugs in cancer pain. Cancer Treat Rev. 2001;27(1):51–61.

    Article  CAS  Google Scholar 

  26. Alanoglu Z, Ates Y, Orbey BC, Turkcapar AG. Preoperative use of selective COX-II inhibitors for pain management in laparoscopic nissen fundoplication. Surg Endosc. 2005;19(9):1182–7.

    Article  CAS  Google Scholar 

  27. Baeriswyl M, Kirkham KR, Kern C, Albrecht E. The analgesic efficacy of ultrasound-guided transversus abdominis plane block in adult patients: a meta-analysis. Anesth Analg. 2015;121(6):1640–54.

    Article  Google Scholar 

  28. Sinha S, Palta S, Saroa R, Prasad A. Comparison of ultrasound-guided transversus abdominis plane block with bupivacaine and ropivacaine as adjuncts for postoperative analgesia in laparoscopic cholecystectomies. Indian J Anaesth. 2016;60(4):264–9.

    Article  CAS  Google Scholar 

  29. Laine L. The gastrointestinal effects of nonselective NSAIDs and COX-2-selective inhibitors. Semin Arthritis Rheum. 2002;32(3 Suppl 1):25–32.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan

    Takuya Saito, Shintaro Kurahashi, Yasuyuki Fukami, Shunichiro Komatsu, Kenitiro Kaneko & Tsuyoshi Sano

  2. Cancer Center, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan

    Shigeyoshi Iwamoto & Hideyuki Mishima

  3. Biostatistics Center, Graduate School of Medicine, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Kenta Murotani

  4. Department of Anesthesiology, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan

    Atsushi Hashimoto

Authors
  1. Takuya Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shigeyoshi Iwamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenta Murotani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atsushi Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shintaro Kurahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasuyuki Fukami
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shunichiro Komatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kenitiro Kaneko
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hideyuki Mishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tsuyoshi Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takuya Saito.

Ethics declarations

Conflict of interest

We have no conflicts of interest to declare.

Ethics statement

The protocol for this research project was approved by the Ethics Committee of our institution and conformed to the provisions of the Declaration of Helsinki. The AMU Ethics Committee and Medical Safety Management Office approved this study (Approval No. 15-H002, UMIN trial ID: 000021842). Informed consent was obtained from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saito, T., Iwamoto, S., Murotani, K. et al. Efficacy of celecoxib as preemptive analgesia for patients undergoing laparoscopic inguinal hernia repair: a randomized trial. Surg Today 51, 1118–1125 (2021). https://doi.org/10.1007/s00595-020-02199-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-020-02199-w

Keyword

Search

Navigation