| JOURNAL HOME | CME HOME | THIS MONTH | PAST ISSUES | ETOC | COLLECTIONS |
| AUTHORS | REVIEWERS | EDITORIAL BOARD | FEEDBACK | RSS | HELP |
| ||||||||||||||
| ||||||||||||||
|
|
|
|
||||||||||||
|
||||||||||||||
*Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas; and
Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Pennsylvania
Address correspondence and reprint requests to P.F. White, PhD, MD, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9068. Address e-mail to paul.white{at}utsouthwestern.edu
Recently, the Food and Drug Administration increased the celecoxib dosage recommendation from 200 mg to 400 mg for acute pain management. No studies have directly compared the analgesic efficacy of different doses of celecoxib for the prevention of postoperative pain. In this prospective, double-blinded, placebo-controlled study, we compared oral celecoxib 200 mg to 400 mg when administered for premedication of outpatients undergoing minor ear-nose-throat surgery. A total of 93 healthy outpatients were assigned to 1 of 3 study groups: control (placebo; n = 30), celecoxib 200 mg (n = 30), or celecoxib 400 mg (n = 33). The study drug was given orally 30–45 min before surgery, and all patients received a standardized general anesthetic technique. During the postoperative period, pain scores (0–10), recovery times, the need for rescue analgesics, quality of recovery (0–100), patient satisfaction with pain management (0–100), and side effects were recorded. Pain was assessed at 30-min intervals using a verbal rating scale, with 0 = no pain to 10 = worst pain imaginable, in the postanesthesia care unit and day surgery unit recovery areas and at 24 h after surgery. Celecoxib 400 mg was significantly more effective than 200 mg (and placebo) in reducing postoperative pain. Both celecoxib 200 mg and 400 mg were more effective than placebo in reducing the postoperative fentanyl requirement (74 ± 67 µg and 56 ± 62 µg versus 120 ± 86 µg, respectively). The larger dose of celecoxib significantly reduced the percentage of patients with severe pain at discharge (6% versus 37% and 30% in the celecoxib 200 mg and control groups, respectively). The median number of doses of oral analgesic medication after discharge was also significantly reduced in the celecoxib 400 mg group (0 versus 2 and 2 in the celecoxib 200 mg and control groups, respectively). However, no differences were found among the three study groups with respect to recovery times and secondary outcome variables (e.g., patient satisfaction and quality of recovery). We conclude that oral premedication with celecoxib 400 mg was more effective than 200 mg in reducing severe postoperative pain and the need for rescue analgesic medication in the postoperative period.
IMPLICATIONS: Oral premedication with celecoxib 400 mg was more effective than 200 mg in reducing postoperative pain and the need for rescue analgesic medication in the early postoperative period. However, neither dose of celecoxib was more effective than a placebo in facilitating the recovery process after outpatient surgery.
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
 |
|
 P. F. White, O. Sacan, B. Tufanogullari, M. Eng, N. Nuangchamnong, and B. Ogunnaike Effect of short-term postoperative celecoxib administration on patient outcome after outpatient laparoscopic surgery: [Effet de l'administration postoperatoire a court terme de celecoxib sur l'evolution des patients apres une chirurgie par laparoscopie sans hospitalisation] Can J Anesth, May 1, 2007; 54(5): 342 - 348. [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]
|
|
|
|
|
|
P. F. White Update on ambulatory anesthesia Can J Anesth, June 1, 2005; 52(suppl_1): R10 - R10. [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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
