Clinical outcome of preoperative analgesia by using celecoxib and parecoxib-sodium for postoperative pain management after posterior thoracic and lumbar surgery

English Keywords:Posterior thoracic and lumbar surgery  Preoperative analgesia  Parecoxib-sodium  Celecoxib  Postoperative pain

English Abstract:

  【Abstract】　Objectives: To observe the clinical outcome of preoperative analgesia by using parecoxib-sodium and celecoxib for postoperative pain management after posterior thoracic and lumbar surgery. Methods: From May 2011 to April 2012, 138 patients undergoing posterior thoracic and lumbar surgery were randomly divided into three groups: celecoxib group(group A, n=46), parecoxib-sodium group(group B, n=46) and preoperative analgesia group in which combined use of parecoxib-sodium and celecoxib was performed(group C, n=46). All of them denied the histories such as peptic ulcer and coronary disease. The pathogenesis included thoracolumbar fractures and degenerative disorders such as lumbar disc herniation and spinal canal stenosis. There was no significant difference with respect to patients′ preoperative general conditions and pain scores(by means of VAS) among three groups（P＞0.05）. Posterior decompression, PLIF or PLF was performed in all patients. The pain scores of 6h, 12h, 24h, 48h, 72h after operation and the dose of tramadol hydrochloride and pethidine hydrochloride used postoperatively and the side effect was recorded respectively. Results: Group C had significantly better analgesic effect than group B and group A（P＜0.05）. Group C had lower average dose of tramadol hydrochloride and pethidine hydrochloride than group A and B（P＜0.05）. Compared with group A, group C had less side effects recorded, which showed significant difference（P＜0.05）. Compared with group B, although group C had less side effects, the difference was not significant（P＞0.05）. Conclusions: Preoperative analgesia by using celecoxib and parecoxib-sodium is effective for postoperative pain management after posterior thoracic and lumbar surgery, and their combined use is superior than separate use, which can lower the dose as well as the rate of side effect.