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Parecoxib vs. lornoxicam in the treatment of postoperative pain after laparoscopic cholecystectomy: a prospective randomized placebo-controlled trial

Published online by Cambridge University Press:  29 August 2006

A. Papadima ,
E. E. Lagoudianakis ,
P. T. Antonakis ,
M. Pattas ,
F. Kremastinou ,
V. Katergiannakis ,
A. Manouras  and
L. Georgiou
A. Papadima
Affiliation:
Hippocrateion Hospital, Athens Medical School, Department of Anesthesiology, Athens, Greece
E. E. Lagoudianakis
Affiliation:
Hippocrateion Hospital, Athens Medical School, First Department of Propaedeutic Surgery, Athens, Greece
P. T. Antonakis
Affiliation:
Hippocrateion Hospital, Athens Medical School, First Department of Propaedeutic Surgery, Athens, Greece
M. Pattas
Affiliation:
Hippocrateion Hospital, Athens Medical School, First Department of Propaedeutic Surgery, Athens, Greece
F. Kremastinou
Affiliation:
Hippocrateion Hospital, Athens Medical School, Department of Anesthesiology, Athens, Greece
V. Katergiannakis
Affiliation:
Hippocrateion Hospital, Athens Medical School, First Department of Propaedeutic Surgery, Athens, Greece
A. Manouras
Affiliation:
Hippocrateion Hospital, Athens Medical School, First Department of Propaedeutic Surgery, Athens, Greece
L. Georgiou
Affiliation:
Hippocrateion Hospital, Athens Medical School, Department of Anesthesiology, Athens, Greece
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Abstract

Summary

Background and objective: Non-steroidal anti-inflammatory drugs are considered as an effective treatment of postoperative pain after laparoscopic cholecystectomy. COX-2 inhibitors are newer drugs having less adverse effects. Data supporting their efficacy postoperatively in comparison to older non-steroidal anti-inflammatory drugs are scarce. Our study is a prospective, randomized, double-blinded, placebo-controlled trial comparing the efficacy of lornoxicam vs. parecoxib for the management of pain after laparoscopic cholecystectomy. Materials and methods: We enrolled 76 patients, ASA I and II, scheduled for elective laparoscopic cholecystectomy. The patients were randomized to receive before induction parecoxib 40 mg i.v., lornoxicam 8 mg i.v. or placebo. Pain at rest and on movement was assessed using a visual analogue scale at 0, 6, 12 h postoperatively. Total meperidine consumption and adverse effects were also recorded. Results: At 12 h, visual analogue scale scores at rest and on movement were significantly lower with parecoxib and lornoxicam compared with control ( P = 0.047). The percentage of patients needing meperidine and the average dose of meperidine administered was significantly lower with parecoxib and lornoxicam compared with control (P < 0.001 and P = 0.018). There was no difference between parecoxib and lornoxicam. One patient receiving lornoxicam vomited. Conclusions: Parecoxib 40 mg i.v. and lornoxicam 8 mg i.v. were equianalgesic and both were more efficacious than placebo for the management of pain after laparoscopic cholecystectomy.

Keywords

SURGERY, abdominalLORNOXICAMPARECOXIBPAIN ACUTE AND POSTOPERATIVECHOLECYSTECTOMY LAPAROSCOPIC
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 2 , February 2007 , pp. 154 - 158
Copyright
2007 European Society of Anaesthesiology

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