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A randomized, placebo-controlled study of rofecoxib with paracetamol in early post-tonsillectomy pain in adults

Published online by Cambridge University Press:  15 September 2005

O. Naesh ,
L. A. Niles ,
J. G. Gilbert ,
M. M. Ammar ,
P. W. Phibbs ,
A. M. Phillips ,
A. V. Khrapov ,
A. J. Robert  and
A. McClintock
O. Naesh
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Anaesthesia, Timaru, New Zealand
L. A. Niles
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Anaesthesia, Timaru, New Zealand
J. G. Gilbert
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Otolaryngology, Timaru, New Zealand
M. M. Ammar
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Otolaryngology, Timaru, New Zealand
P. W. Phibbs
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Otolaryngology, Timaru, New Zealand
A. M. Phillips
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Anaesthesia, Timaru, New Zealand
A. V. Khrapov
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Anaesthesia, Timaru, New Zealand
A. J. Robert
Affiliation:
Timaru Hospital and Bidwill Trust Hospital, Department of Anaesthesia, Timaru, New Zealand
A. McClintock
Affiliation:
Timaru Hospital, Pharmacy Department, Timaru, New Zealand
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Extract

Summary

Background and objective: Effective and early treatment of postoperative pain and nausea have become pivotal for the early discharge of patients after tonsillectomy. Opioid-based analgesia is standard practice but the use of non-steroidal anti-inflammatory drugs is discouraged due to their platelet inhibiting properties. The cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drugs are effective analgesics and do not affect platelet function. We hypothesized that premedication with cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug in addition to paracetamol would provide effective analgesia and decrease opioid consumption during early recovery from tonsillectomy. Methods: In a randomized, placebo-controlled study of adult tonsillectomy patients (n = 40) one group (R-group; n = 20) was premedicated with paracetamol 1.5 g and rofecoxib 50 mg and a control group (P-group; n = 20) was premedicated with paracetamol 1.5 g and placebo. Morphine was used as rescue medication. Postoperative (24 h) pain scores (0–10), morphine consumption as well as intraoperative blood loss were recorded. Results: We found no overall difference in pain scores between the groups but significantly more patients in the placebo group had pain scores >5 within the first 8 h. The rofecoxib group consumed less morphine during the first 12 h. A lower intraoperative blood loss was observed in the rofecoxib group. Conclusion: Our results suggest an early although clinically minor analgesic benefit of the addition of a cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug to paracetamol as premedication for adult tonsillectomy.

Keywords

ANTI-INFLAMMATORY AGENTS, NONSTEROIDAL, paracetamol, rofecoxibPOSTOPERATIVE PAINTONSILLECTOMY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 10 , October 2005 , pp. 768 - 773
Copyright
© 2005 European Society of Anaesthesiology

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