comparison the efficacy of pre-emptive oral celecoxib with acetaminophen in controlling post-operative pain and nausea after lower limb surgery under general anesthesia

Introduction

Up to now, there is no single opinion on how to control pain after surgeryand molecular and clinical research in this area has been continuing. This study aimed to compare the effect of premedication with oral administration of celecoxib and acetaminophen on postoperative pain relief in the lower extremity surgery under general anesthesia.

Materials and methods:

In a prospective, randomized, double-blinded, clinical trial study, 70 patients undergoing lower limb surgery under general anesthesia were distributed into two equal groups. In the first and second group, oral acetaminophen 1000 mg orcelecoxib 400 mg capsules were prescribed one hour before the operation, respectively. Postoperative painand nausea severity in both groups were evaluatedby VAS score and compared with each other.

Results

Assessment of pain intensity at 1, 2, 6, 12 and 24 hours after surgery revealed that acetaminophen group at the first hour had more intensity of  postoperative pain (5.46±1.17) compared with celecoxib group(4.31±1.32)(P <0.001). In the rest of the time, there was no significant difference between the two groups. Analysis of variance with repeated observations showed, the trend of postoperative pain intensity during the study in both groups had a significant difference (p = 0.013). The intensity of nausea in the first hour after surgery was significantly more in acetaminophen group compared with celecoxib group (2.8±1.1 vs. 2.2±1.3, p<0.034).

Conclusions:

Celecoxib may be a better choice in reducing pain and nausea after surgery compared with acetaminophen. Considering no significant adverse effects in many studies, celecoxib may be used as a pre-emptive medication to reduce pain after lower extremity surgery.

Key words: Premedication, Post-operative, PONV, pain, Celecoxib, Acetaminophen