A Multimodal Analgesia of Cyclooxygenase-2 for Postoperative Pain

[摘要] Recently, Interest to multimodal analgesia, using of two or more analgesics and modalities to treatment of postoperative pain is rising. The aim of this study was to assess the effect of celecoxib on pain and associated complications after lumbar disc surgery. In a randomized, double- blind, placebo- controlled trial, 76 patients scheduled for elective laminectomy divided into two groups. Group A : celecoxib group ( n=38, received celecoxib 400 mg 2hrs before surgery and 200 mg 6 hrs after surgery, along with morphine), Group B : control group ( n=38, received placebo tablets at the same time along with morphine). Visual Analog Scale (VAS) was used to determine the severity of pain. Complications after surgery, anxiety scores before surgery and patient’s satisfaction 24 h after surgery were recorded. The mean pain severity score and morphine consumption in the celecoxib group were less compared to the control group at various intervals (P < 0.001). The mean anxiety score(2.2 vs 3), shivering (23.6% vs 42.1%), nausea (18.4% vs 44.7%), vomiting (13.1% vs 39.5%) and Pruritus (18.4% vs 44.7%) in the celecoxib group were significantly lower compared to the control groups, respectively (P < 0.001, P < 0.05). Not significantly differences were observed between groups in relation to blood loss (331.12 vs 335.17), drowsiness (13.2% vs 5.3%) ,dizziness (26.3% vs 21.1%) and headache (13.2% vs 10.5%), respectively (p> 0.05). In the celecoxib group patient satisfaction was significantly higher compared to the control group (p< 0.001). Celecoxib 400 mg 2 hrs before surgery and 200 mg 6 hrs after surgery is a good alternative in multimodal analgesia, effective in pain control with lesser side effects seen with morphine alone in patients’ pain management following lumbar disc surgery.

[学科分类] 药理学