Effects of parecoxib on analgesia benefit and blood loss following open prostatectomy: a multicentre randomized trial

BMC Anesthesiology

Daniel Dirkmann¹  Harald Groeben²  Hassan Farhan³  David L Stahl³  Matthias Eikermann³ 

[1] Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Universitätsklinikum Essen, Hufelandstrasse 55, Essen D-45144, Germany

[2] Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Kliniken Essen Mitte, Henricistrasse 92, Essen 45136, Germany

[3] Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, MA, USA

关键词: Postoperative pain;    Pain;    Morphine;    Analgesics opioids;    Parecoxib;    Analgesics non-opioids;   

Others  :  1136946
DOI  :  10.1186/s12871-015-0015-y

 received in 2014-02-28, accepted in 2015-02-24,  发布年份 2015

【 摘 要 】

Background

This multi-centre, prospective, randomized, double-blind, placebo-controlled study was designed to test the hypotheses that parecoxib improves patients’ postoperative analgesia without increasing surgical blood loss following radical open prostatectomy.

Methods

105 patients (64 ± 7 years old) were randomized to receive either parecoxib or placebo with concurrent morphine patient controlled analgesia. Cumulative opioid consumption (primary objective) and the overall benefit of analgesia score (OBAS), the modified brief pain inventory short form (m-BPI-sf), the opioid-related symptom distress scale (OR-SDS), and perioperative blood loss (secondary objectives) were assessed.

Results

In each group 48 patients received the study medication for 48 hours postoperatively. Parecoxib significantly reduced cumulative opioid consumption by 24% (43 ± 24.1 mg versus 57 ± 28 mg, mean ± SD, p=0.02), translating into improved benefit of analgesia (OBAS: 2(0/4) versus 3(1/5.25), p=0.01), pain severity (m-BPI-sf: 1(1/2) versus 2(2/3), p < 0.01) and pain interference (m-BPI-sf: 1(0/1) versus 1(1/3), p=0.001), as well as reduced opioid-related side effects (OR-SDS score: 0.3(0.075/0.51) versus 0.4(0.2/0.83), p=0.03). Blood loss was significantly higher at 24 hours following surgery in the parecoxib group (4.3 g⋅dL⁻¹ (3.6/4.9) versus (3.2 g⋅dL⁻¹ (2.4/4.95), p=0.02).

Conclusions

Following major abdominal surgery, parecoxib significantly improves patients’ perceived analgesia. Parecoxib may however increase perioperative blood loss. Further trials are needed to evaluate the effects of selective cyclooxygenase-2 inhibitors on blood loss.

Trial registration

ClinicalTrials.gov Identifier: NCT00346268 webcite

【 授权许可】

   
2015 Dirkmann et al.; licensee BioMed Central.

【 图 表 】

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