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AMBULATORY ANESTHESIA

A Randomized, Double-Blind Comparison Between Parecoxib Sodium and Propacetamol for Parenteral Postoperative Analgesia After Inguinal Hernia Repair in Adult Patients

M. Beaussier, MD^*, H. Weickmans, MD^*, C. Paugam, MD^*, S. Lavazais, MD, J. P. Baechle, MD, P. Goater, MD, A. Buffin, MD^||, J. F. Loriferne, MD^¶, J. F. Perier, MD^#, J. P. Didelot, MD^**, A. Mosbah, MD, R. Said, MD, and A. Lienhart, MD, PhD^*

*CHU St. Antoine, Paris, France; CHU Poitiers, France; Clinique de la Sauvegarde, Lyon, France; HIA Val de Grâce, Paris, France; ||CHU Annecy, France; ¶Hôpital Ste Camille, Bry sur Marne, France; #CHU Tenon, Paris, France; **CHU Brabois, Vandoeuvre, les Nancy, France; and CHU Sahloul, Sousse, Tunisie

Address correspondence and reprint requests to M. Beaussier, MD, Département d’Anesthésie Réanimation, Hôpital St-Antoine, 184 rue du Fbg St-Antoine, 75012 Paris, France. Address e-mail to marc.beaussier{at}sat.ap-hop-paris.fr.

The newly injectable cyclooxygenase-2 selective nonsteroidal antiinflammatory drug, parecoxib, has never been compared with propacetamol, a parenteral formulation of acetaminophen. In this prospective, randomized, double-blind, double-dummy study, we randomly assigned 182 patients scheduled for initial inguinal hernia repair under general anesthesia to receive a single injection of 40 mg parecoxib or 2 injections of 2 g propacetamol within the first 12 h after surgery. The study variables were morphine consumption, pain at rest and while coughing, and patient satisfaction throughout the first 12 h postoperatively. For statistical analysis, we used the Student’s t-test, ², and covariance analysis. Total morphine consumption did not differ between the two groups. Pain was less intense in the parecoxib group at rest (P = 0.035) but did not differ for pain while coughing. The incidence of side effects was similar. Significantly more patients in the parecoxib group rated their pain management as good or excellent (87% versus 70% in the propacetamol group, P = 0.001). Within the first 12 h after inguinal hernia repair in adult patients, a single injection of parecoxib 40 mg compares favorably with 2 injections of propacetamol 2 g.

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