Xin Lu1, Kanghua Li. 1. Department of Orthopaedic Surgery, Xiangya Hospital, Central South University, Changsha 410078, China.
Abstract
OBJECTIVE: To determine the multimodal postoperative analgesia effect of celecoxib combined with patient-controlled analgesia (PCA) and its clinical efficacy and related adverse events in orthopaedic procedures. METHODS:Sixty patients undergoing orthopaedic surgery were randomly divided into 2 groups. The observation group received 400 mg of celecoxib from POD0 to POD5 and 200 mg until POD14 plus IV PCA (fentanyl 1.0 mg/100 mL) postoperatively. The control group only took IV PCA postoperatively plus placebo. Visual analogue scale (VAS) scores and cumulative volumes of the opioid were assessed every 4 hours postoperatively until 48 hours. Sleep disturbance, vital signs and side effects including nausea, emesis, et al. were observed for 2 days. Blood-R and coagulation function were tested preoperatively and postoperatively. Blood loss, satisfied score, and chronic pain situation at 1 month were also measured. RESULTS:VAS scores, sleep disturbance, PCA cumulative volumes of the fentanyl were significantly better in the multimodal groups compared with the simple analgesia group (P<0.05), the opioid and celecoxib related adverse effects were not statistically lower in the multimodal groups (P>0.05). The observation group was more satisfied with analgesia treatment and experienced less pain 1 month after discharge (P<0.05). CONCLUSION: The multimodal use of the specific COX-2 inhibitor celecoxib in the postoperative period of orthopaedic procedures clearly improves postoperative pain, reduces the opioid consumption, releases the sleep disturbance, demonstrates more satisfaction in patients and lower chronic pain rate after discharge, without affecting the platelet and coagulation function.
RCT Entities:
OBJECTIVE: To determine the multimodal postoperative analgesia effect of celecoxib combined with patient-controlled analgesia (PCA) and its clinical efficacy and related adverse events in orthopaedic procedures. METHODS: Sixty patients undergoing orthopaedic surgery were randomly divided into 2 groups. The observation group received 400 mg of celecoxib from POD0 to POD5 and 200 mg until POD14 plus IV PCA (fentanyl 1.0 mg/100 mL) postoperatively. The control group only took IV PCA postoperatively plus placebo. Visual analogue scale (VAS) scores and cumulative volumes of the opioid were assessed every 4 hours postoperatively until 48 hours. Sleep disturbance, vital signs and side effects including nausea, emesis, et al. were observed for 2 days. Blood-R and coagulation function were tested preoperatively and postoperatively. Blood loss, satisfied score, and chronic pain situation at 1 month were also measured. RESULTS: VAS scores, sleep disturbance, PCA cumulative volumes of the fentanyl were significantly better in the multimodal groups compared with the simple analgesia group (P<0.05), the opioid and celecoxib related adverse effects were not statistically lower in the multimodal groups (P>0.05). The observation group was more satisfied with analgesia treatment and experienced less pain 1 month after discharge (P<0.05). CONCLUSION: The multimodal use of the specific COX-2 inhibitor celecoxib in the postoperative period of orthopaedic procedures clearly improves postoperative pain, reduces the opioid consumption, releases the sleep disturbance, demonstrates more satisfaction in patients and lower chronic pain rate after discharge, without affecting the platelet and coagulation function.