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British Journal of Anaesthesia, 2003, Vol. 90, No. 6 746-749
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Analgesic effects of parecoxib following total abdominal hysterectomy{dagger}{ddagger}

A. Ng, G. Smith and A. C. Davidson1

University Department of Anaesthesia, Critical Care and Pain Management and 1 Department of Obstetrics and Gynaecology, Leicester Royal Infirmary, Leicester LE1 5WW, UK

{ddagger}Declaration of interest. The authors are grateful to Pharmacia for an educational grant for this trial.

Background. Forty-eight ASA I–II patients undergoing total abdominal hysterectomy (TAH) were studied in a double blind, randomized placebo controlled trial of parecoxib for postoperative analgesia.

Methods. All patients were given propofol 2–4 mg kg–1 i.v., a non-depolarizing muscle relaxant, morphine 10 mg i.v. and prochlorperazine 12.5 mg i.m. intraoperatively. Their lungs were ventilated with nitrous oxide and isoflurane 1–1.5% in oxygen. Morphine was self-administered for postoperative analgesia via a patient controlled analgesia (PCA) device. Patients were allocated randomly to receive either parecoxib 40 mg i.v. or normal saline on induction of anaesthesia.

Results. Twelve patients did not complete the study. Of the remaining 36 patients, there was no significant difference between the treatment groups in age, weight, ASA status, duration of surgery, or intraoperative dose of morphine. However, mean (95% CI) 24 h morphine consumption of 54 (42–65) mg in the parecoxib group was significantly (P=0.04) lower than that of 72 (58–86) mg in the placebo group. Pain intensity scores on sitting up were significantly lower (P=0.02) in the parecoxib group compared with placebo. There was no significant difference between the treatment groups in pain intensity scores at rest and on deep inspiration, or in nausea, total number of vomiting episodes, median number of rescue antiemetic doses, and sedation scores.

Conclusions. Parecoxib 40 mg i.v. may be recommended in patients having TAH as it provides morphine-sparing analgesia.

Br J Anaesth 2003; 90: 746–9


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