Abstract
Background
This randomized, double-blind, prospective, placebo controlled study was planned to determine the effectiveness of selective COX-II inhibitors used preoperatively to alleviate pain after Nissen fundoplication surgery.
Methods
For this study, 60 patients were allocated to four groups at random: group C (celecoxib, 200 mg by mouth), group R (rofecoxib, 50 mg by mouth), group P (placebo, pill), or group D (diclophenac sodium, 75 mg intramuscularly). Postoperative abdominal and shoulder pain experienced by the patient at rest, with motion, and with coughing were assessed. Side effects and postoperative analgesic requirement (tramadol, intramuscular) also were recorded.
Results
The median tramadol requirement in the 1st h and total tramadol requirement at the 24th h were higher in group P than in the other study groups (p < 0.0l). The pain scores in the first postoperative hour were higher in group P (p < 0.05).
Conclusions
The preoperative use of celecoxib, rofecoxib, or diclophenac in laparoscopic Nissen fundoplication surgery decreases pain intensity and tramadol requirement in the first postoperative hour and has a trarnadol sparing effect in the first 24 h.
Similar content being viewed by others
References
Clemett D, Goa KL (2000) Celecoxib: a review of its use in osteoarthritis, rheumatoid arthritis, and acute pain. Drugs 59: 957–980
Fitzgerald GA, Patrono C (2001) The coxibs, selective inhibitors of cyclooxygenase-2. N Engl J Med 345: 433–442
Gajraj NM, (2003) Cyclooxygenase-2 inhibitors. Anesth Analg 96: 1720–1738
Gimbel JS, Brugger A, Zhao W, Verburg KM, Geis GS (2001) Efficacy and tolerability of celecoxib versus hydrocodone/acetominophen in the treatment of pain after ambulatory orthopedic surgery in adults. Clin Ther 23: 228–241
Huang JJ, Taguchi A, Hsu H, Andriole GL Jr, Kurz A (2001) Preoperative oral rofecoxib does not decrease postoperative pain or morphine consumption in patients after radical prostatectomy: a prospective, randomized, double-blinded, placebo-controlled trial. J Clin Anesth 13: 94–97
Issioui T, Klein KW, White PF, Watcha MF, Skrivanek GD, Jones SB, Hu J, Marple BF, Ing C (2002) The efficacy of premedication with celecoxib and acetaminophen in preventing pain after otolaryngologic surgery. Anesth Analg 94: 1188–1193
Joris J, Cigarini I, Legrand M, Jacquet N, De Groote D, Franchimont P, Lamy M (1992) Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy. Br J Anaesth 69: 341–345
Karamanlioglu B, Arar C, Alagöl A, Colak A, Gemlik I, Sut N (2003) Preoperative oral celecoxib versus preoperative oral rofecoxib for pain relief after thyroid surgery. Eur J Anaesth 20: 490–495
Kharasch ED, (2004) Perioperative COX-2 inhibitors: knowledge and challenges. Anesth Analg 98: 1–3
Liu J, Ding Y, White PF, Feinstein R, Shear JM (1993) Effects of ketorolac on postoperative analgesia and ventilatory function after laparoscopic cholecystectomy. Anesth Analg 76: 106–106
McCrory CR, Lindahl SGE (2002) Cyclooxygenase inhibition for postoperative analgesia. Anesth Analg 95: 169–176
Mealy K, Gallagher H, Barry M, Lennon F, Traynor O, Hyland J (1992) Physiological and metabolic responses to open and laparoscopic cholecystectomy. Br J Surgery 79: 1061–1064
Milford MA, Paluch TA (1997) Ambulatory laparoscopic fundoplication. Surg Endosc 11: 1150–1152
Pierre AF, Luketich JD, Fernando HC, Christie NA, Buenaventura PO, Litle VR, Schauer PR (2002) Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg 74: 1909–1916
Putland AJ, McCluskey A (1999) The analgesic efficacy of tramadol versus ketorolac in day-case laparoscopic sterilization. Anaesthesia 54: 372–392
Recart A, Issioui T, White PF, Klein K, Watcha MF, Stool L, Shah M (2003) The efficacy of celecoxib premedication on postoperative pain and recovery times after ambulatory surgery: a dose-ranging study. Anesth Analg 96: 1631–1635
Rueben SS, Connelly NR (2000) Postoperative analgesic effects of celecoxib or rofecoxib after spinal fusion surgery. Anesth Analg 91: 1221–1225
Sinatra RS, Shen QJ, Halaszynski T, Luther MA, Shaheen Y (2004) Preoperative rofecoxib oral suspension as an analgesic adjunct after lower abdominal surgery: the effects on effort-dependent pain and pulmonary function. Anesth Analg 98: 135–140
Van Hecken A, Schwartz JI, Depre M, De Lepeleire I, Dallob A, Tanaka W, Wynants K, Buntinx A, Arnout J, Wong PH, Ebel DL, Gertz BJ, De Schepper PJ (2000) Comparative inhibitory activity of rofecoxib, meloxicam, diclofenac, ibuprofen, and naproxen on COX-2 versus COX-1 in healthy volunteers. J Clin Pharmacol 40: 1109–1120
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented at the European Society of Anaesthesia Annual Meeting 5–8 June 2004, Lisbon Portugal
Rights and permissions
About this article
Cite this article
Alanoglu, Z., Ateş, Y., Orbey, B.C. et al. Preoperative use of selective COX-II inhibitors for pain management in laparoscopic nissen fundoplication. Surg Endosc 19, 1182–1187 (2005). https://doi.org/10.1007/s00464-004-8254-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-004-8254-x