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PAIN MEDICINE

The Cyclooxygenase-2-Specific Inhibitor Parecoxib Sodium Is as Effective as 12 mg of Morphine Administered Intramuscularly for Treating Pain After Gynecologic Laparotomy Surgery

T. Philip Malan, Jr, MD, PhD^*, Stephen Gordon, MD, Richard Hubbard, MD, and Michael Snabes, MD

*Department of Anesthesiology, The University of Arizona, Tucson, Arizona; Comprehensive NeuroScience Inc., Atlanta, Georgia; and Pfizer Global Pharmaceuticals, Skokie, Illinois

Address correspondence and reprint requests to T. Philip Malan, Jr., MD, PhD, Department of Anesthesiology, The University of Arizona, 1501 N. Campbell Ave., PO Box 245114, Tucson, AZ 85724-5114. Address e-mail to malan{at}u.arizona.edu.

Parecoxib sodium, the injectable prodrug of valdecoxib, is a cyclooxygenase-2-specific inhibitor that is effective in the treatment of postoperative pain. In this randomized, double-blind, placebo-controlled study, we compared the efficacy of a single dose of parecoxib sodium 40 mg IM with single doses of morphine 6 and 12 mg IM in treating postoperative pain after gynecologic surgery requiring a laparotomy incision. By nearly all efficacy measures (including total pain relief and patient's global evaluation of study medication), parecoxib sodium 40 mg IM demonstrated pain relief and a decrease in pain intensity that was statistically similar to that with morphine 12 mg IM and superior to that with morphine 6 mg IM. Parecoxib sodium 40 mg IM-treated patients also demonstrated a longer time to use of rescue medication than patients treated with both morphine doses, and this dose provided sustained pain relief over the 12-h study period. The incidence of adverse events in the active treatment groups was similar to that observed with placebo. Parecoxib sodium, 40 mg IM, has been shown to be as effective as clinically relevant doses of morphine in patients after gynecologic laparotomy surgery.

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