| JOURNAL HOME | CME HOME | THIS MONTH | PAST ISSUES | ETOC | COLLECTIONS |
| AUTHORS | REVIEWERS | EDITORIAL BOARD | FEEDBACK | RSS | HELP |
| ||||||||||||||
| ||||||||||||||
|
|
|
|
||||||||||||
|
||||||||||||||
Department of Anesthesiology, Baystate Medical Center, Springfield, Massachusetts
Address correspondence and reprint requests to Scott S. Reuben, MD, Department of Anesthesiology, Baystate Medical Center, 759 Chestnut St., Springfield, MA 01199. Address e-mail to scott .reuben{at}bhs.org
Nonsteroidal antiinflammatory drugs are recommended for the multimodal management of postoperative pain and may have a significant opioid-sparing effect after major surgery. The analgesic efficacy of the cyclooxygenase-2 nonsteroidal antiinflammatory drugs, celecoxib and rofecoxib, have not been evaluated after major orthopedic surgery. This study was designed to determine whether the administration of a preoperative dose of celecoxib or rofecoxib to patients who have undergone spinal stabilization would decrease patient-controlled analgesia (PCA) morphine use and/or enhance analgesia. We evaluated 60 inpatients undergoing spine stabilization by one surgeon. All patients received PCA morphine. The patients were divided into three groups. Preoperatively, they were given oral celecoxib 200 mg, rofecoxib 50 mg, or placebo. The outcome measures included pain scores and 24-h morphine use at six times during the first 24 postoperative h. The total dose of morphine and the cumulative doses for each of the six time periods were significantly more in the placebo group than in the other two groups. The morphine dose was significantly less in five of the six time intervals in the rofecoxib group compared with the celecoxib group. The pain scores were significantly less in the rofecoxib group than in the other two groups at two of the six intervals, and less than the placebo group in an additional interval. Although both rofecoxib and celecoxib produce similar analgesic effects in the first 4 h after surgery, rofecoxib demonstrated an extended analgesic effect that lasted throughout the 24-h study. We thus recommend that rofecoxib be used as a preoperative component of pain management that includes PCA morphine in patients undergoing spine stabilization surgery.
Implications: The cyclooxygenase-2-specific nonsteroidal antiinflammatory drugs, celecoxib and rofecoxib, both demonstrate an opioid-sparing effect after spinal fusion surgery. Celecoxib resulted in decreased morphine use for the first 8 h after surgery, whereas rofecoxib demonstrated less morphine use throughout the 24-h study period.
This article has been cited by other articles:
|
|
 |
|
  M. Benish, I. Bartal, Y. Goldfarb, B. Levi, R. Avraham, A. Raz, and S. Ben-Eliyahu Perioperative Use of {beta}-blockers and COX-2 Inhibitors May Improve Immune Competence and Reduce the Risk of Tumor Metastasis Ann. Surg. Oncol., July 1, 2008; 15(7): 2042 - 2052. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Sun, O. Sacan, P. F. White, J. Coleman, R. J. Rohrich, and J. M. Kenkel Perioperative Versus Postoperative Celecoxib on Patient Outcomes After Major Plastic Surgery Procedures Anesth. Analg., March 1, 2008; 106(3): 950 - 958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Schenk, M. Putzier, B. Kugler, S. Tohtz, K. Voigt, T. Schink, W. J. Kox, C. Spies, and T. Volk Postoperative Analgesia After Major Spine Surgery: Patient-Controlled Epidural Analgesia Versus Patient-Controlled Intravenous Analgesia Anesth. Analg., November 1, 2006; 103(5): 1311 - 1317. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. T. Horlocker, S. L. Kopp, M. W. Pagnano, and J. R. Hebl Analgesia for total hip and knee arthroplasty: a multimodal pathway featuring peripheral nerve block. J. Am. Acad. Ortho. Surg., March 1, 2006; 14(3): 126 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bainbridge, D. C. Cheng, J. E. Martin, R. Novick, and The Evidence-Based Perioperative Clinical Outcomes NSAID-analgesia, pain control and morbidity in cardiothoracic surgery: [L'analgesie avec des AINS, le controle de la douleur et la morbidite en chirurgie cardiothoracique] Can J Anesth, January 1, 2006; 53(1): 46 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Turan, P. F. White, B. Karamanlioglu, D. Memis, M. Tasdogan, Z. Pamukcu, and E. Yavuz Gabapentin: An Alternative to the Cyclooxygenase-2 Inhibitors for Perioperative Pain Management Anesth. Analg., January 1, 2006; 102(1): 175 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. F. White The Changing Role of Non-Opioid Analgesic Techniques in the Management of Postoperative Pain Anesth. Analg., November 1, 2005; 101(5S_Suppl): S5 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Reuben, D. Ablett, and R. Kaye High dose nonsteroidal anti-inflammatory drugs compromise spinal fusion: [De fortes doses d'anti-inflammatoires non steroidiens compromettent l'arthrodese vertebrale] Can J Anesth, May 1, 2005; 52(5): 506 - 512. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. F. White Changing Role of COX-2 Inhibitors in the Perioperative Period: Is Parecoxib Really the Answer? Anesth. Analg., May 1, 2005; 100(5): 1306 - 1308. [Full Text] [PDF]
|
|
|
|
|
|
A. Buvanendran, J. S. Kroin, K. J. Tuman, T. R. Lubenow, D. Elmofty, and P. Luk Cerebrospinal Fluid and Plasma Pharmacokinetics of the Cyclooxygenase 2 Inhibitor Rofecoxib in Humans: Single and Multiple Oral Drug Administration Anesth. Analg., May 1, 2005; 100(5): 1320 - 1324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Ruppen and G. K. Schupfer Exacerbation of Carpal Tunnel Syndrome Under Treatment with Valdecoxib Anesth. Analg., April 1, 2005; 100(4): 1215 - 1216. [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Reuben and E. F. Ekman The Effect of Cyclooxygenase-2 Inhibition on Analgesia and Spinal Fusion J. Bone Joint Surg. Am., March 1, 2005; 87(3): 536 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. T. G. Rahusen, P. S. Weinhold, and L. C. Almekinders Nonsteroidal Anti-inflammatory Drugs and Acetaminophen in the Treatment of an Acute Muscle Injury Am. J. Sports Med., December 1, 2004; 32(8): 1856 - 1859. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Pertusi Selective Cyclooxygenase Inhibition in Pain Management J Am Osteopath Assoc, November 1, 2004; 104(11_suppl): 19S - 24S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. D. Jackson, B. H. Heidemann, J. Wilson, I. Power, and R. D. Brown Double-blind, randomized, placebo-controlled trial comparing rofecoxib with dexketoprofen trometamol in surgical dentistry Br. J. Anaesth., May 1, 2004; 92(5): 675 - 680. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. R. Hegi, T. Bombeli, B. Seifert, P. C. Baumann, U. Haller, M. P. Zalunardo, T. Pasch, and D. R. Spahn Effect of rofecoxib on platelet aggregation and blood loss in gynaecological and breast surgery compared with diclofenac Br. J. Anaesth., April 1, 2004; 92(4): 523 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Ma, J. Tang, P. F. White, A. Zaentz, R. H. Wender, A. Sloninsky, R. Naruse, R. Kariger, R. Quon, D. Wood, et al. Perioperative Rofecoxib Improves Early Recovery After Outpatient Herniorrhaphy Anesth. Analg., April 1, 2004; 98(4): 970 - 975. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Karamanlioglu, A. Turan, D. Memis, and M. Ture Preoperative Oral Rofecoxib Reduces Postoperative Pain and Tramadol Consumption in Patients After Abdominal Hysterectomy Anesth. Analg., April 1, 2004; 98(4): 1039 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Sinatra, Q. J. Shen, T. Halaszynski, M. A. Luther, and Y. Shaheen Preoperative Rofecoxib Oral Suspension as an Analgesic Adjunct After Lower Abdominal Surgery: The Effects on Effort-Dependent Pain and Pulmonary Function Anesth. Analg., January 1, 2004; 98(1): 135 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Raw, J. K. Beattie, and J. M. Hunter Anaesthesia for spinal surgery in adults Br. J. Anaesth., December 1, 2003; 91(6): 886 - 904. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Silverman, T. Halaszynski, R. Sinatra, M. Luther, and C. S. Rinder Rofecoxib does not compromise platelet aggregation during anesthesia and surgery: [Le rofecoxib n'altere pas l'agregation plaquettaire pendant l'anesthesie et la chirurgie] Can J Anesth, December 1, 2003; 50(10): 1004 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Pavlin, K. D. Horvath, E. G. Pavlin, and K. Sima Preincisional Treatment to Prevent Pain After Ambulatory Hernia Surgery Anesth. Analg., December 1, 2003; 97(6): 1627 - 1632. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Buvanendran, J. S. Kroin, K. J. Tuman, T. R. Lubenow, D. Elmofty, M. Moric, and A. G. Rosenberg Effects of Perioperative Administration of a Selective Cyclooxygenase 2 Inhibitor on Pain Management and Recovery of Function After Knee Replacement: A Randomized Controlled Trial JAMA, November 12, 2003; 290(18): 2411 - 2418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. S. Koo Acute Pain Management Journal of Pharmacy Practice, August 1, 2003; 16(4): 231 - 248. [Abstract] [PDF]
|
|
|
|
 |
|
 A. T. Harder and Y. H. An The Mechanisms of the Inhibitory Effects of Nonsteroidal Anti-Inflammatory Drugs on Bone Healing: A Concise Review J. Clin. Pharmacol., August 1, 2003; 43(8): 807 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Joshi, N. R. Connelly, S. S. Reuben, M. Wolckenhaar, and N. Thakkar An Evaluation of the Safety and Efficacy of Administering Rofecoxib for Postoperative Pain Management Anesth. Analg., July 1, 2003; 97(1): 35 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ng, G. Smith, and A. C. Davidson Analgesic effects of parecoxib following total abdominal hysterectomy{dagger}{ddagger} Br. J. Anaesth., June 1, 2003; 90(6): 746 - 749. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Recart, T. Issioui, P. F. White, K. Klein, M. F. Watcha, L. Stool, and M. Shah The Efficacy of Celecoxib Premedication on Postoperative Pain and Recovery Times After Ambulatory Surgery: A Dose-Ranging Study Anesth. Analg., June 1, 2003; 96(6): 1631 - 1635. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M. Gajraj Cyclooxygenase-2 Inhibitors Anesth. Analg., June 1, 2003; 96(6): 1720 - 1738. [Full Text] [PDF]
|
|
|
|
|
|
M. F. Watcha, T. Issioui, K. W. Klein, and P. F. White Costs and Effectiveness of Rofecoxib, Celecoxib, and Acetaminophen for Preventing Pain After Ambulatory Otolaryngologic Surgery Anesth. Analg., April 1, 2003; 96(4): 987 - 994. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Niederberger, I. Tegeder, C. Schafer, M. Seegel, S. Grosch, and G. Geisslinger Opposite Effects of Rofecoxib on Nuclear Factor-kappa B and Activating Protein-1 Activation J. Pharmacol. Exp. Ther., March 1, 2003; 304(3): 1153 - 1160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Hubbard, T. M. Naumann, L. Traylor, and S. Dhadda Parecoxib sodium has opioid-sparing effects in patients undergoing total knee arthroplasty under spinal anaesthesia Br. J. Anaesth., February 1, 2003; 90(2): 166 - 172. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Turan, S. Emet, B. Karamanlioglu, D. Memis, N. Turan, and Z. Pamukcu Analgesic Effects of Rofecoxib in Ear-Nose-Throat Surgery Anesth. Analg., November 1, 2002; 95(5): 1308 - 1311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Issioui, K. W. Klein, P. F. White, M. F. Watcha, M. Coloma, G. D. Skrivanek, S. B. Jones, K. C. Thornton, and B. F. Marple The Efficacy of Premedication with Celecoxib and Acetaminophen in Preventing Pain After Otolaryngologic Surgery Anesth. Analg., May 1, 2002; 94(5): 1188 - 1193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Sinatra MD, J. Torres, and A. M. Bustos Pain Management After Major Orthopaedic Surgery: Current Strategies and New Concepts J. Am. Acad. Ortho. Surg., March 1, 2002; 10(2): 117 - 129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. F. White The Role of Non-Opioid Analgesic Techniques in the Management of Pain After Ambulatory Surgery Anesth. Analg., March 1, 2002; 94(3): 577 - 585. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Pickering, H. S. Bridge, J. Nolan, and P. A. Stoddart Double-blind, placebo-controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children Br. J. Anaesth., January 1, 2002; 88(1): 72 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Reuben, S. Bhopatkar, H. Maciolek, W. Joshi, and J. Sklar The Preemptive Analgesic Effect of Rofecoxib After Ambulatory Arthroscopic Knee Surgery Anesth. Analg., January 1, 2002; 94(1): 55 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Matsumura and S. S. Reuben Considerations in the Use of COX-2 Inhibitors in Spinal Fusion Surgery Response Anesth. Analg., September 1, 2001; 93(3): 803 - 804. [Full Text] [PDF]
|
|
|
|
|
|
S. S. Reuben and J. Sklar Pain Management in Patients Who Undergo Outpatient Arthroscopic Surgery of the Knee J. Bone Joint Surg. Am., December 1, 2000; 82(12): 1754 - 1754. [Full Text]
|
|
|
