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

Daniel Dirkmann, Harald Groeben, Hassan Farhan, David L. Stahl, Matthias Eikermann

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number31
JournalBMC Anesthesiology
Volume15
Issue number1
DOIs
StatePublished - Mar 9 2015
Externally publishedYes

Keywords

  • Analgesics non-opioids
  • Analgesics opioids
  • Morphine
  • Pain
  • Parecoxib
  • Postoperative pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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