Enliven: Journal of Anesthesiology and Critical Care Medicine

The Effect of Preemptive Oral Celecoxib on Pain Reduction and Opioid Consumption during Elective Herniorrhaphy
Author(s): Maziar Mahjoubifard MD, Hasan Enayati MD, NoorMohammad Noori MD, Mahdy Shaikh MD, and Alireza Jahangiri Fard MD

Introduction: Pain control is an important aspect in postoperative care. While opioids proved excellent analgesia undesirable side effects such as respiratory depression, nausea and vomiting, constitute major limitation. As a result, many surgical centers used NSAIDs for controlled acute pain of surgery. Celecoxib is NSAIDs that inhibits cox2, but it does not have GI side effect and coagulopathy disorder. The aim of this study was to determine the effect of preemptive celexib on pain score reduction and opioid consumption after herniorrhaphy.

Material and Method: This is a randomised double blinded clinical trial study which performed in Imam Ali and Khatam hospital in zahedan. 76 patients scheduled for elective herniorrhaphy were enroled in this study. Patients were divided into 2GROUPS; celexib group (n=38) and placebo group (n=38). Drugs (placebo or 200mg celexib) were given (oraly) 2 hours before operation to patients. All patients general anesthetized with midazolam (1-2mg), fentanyl (1-2μg/kg) for premedication; nesdonal (4-6mg/kg) and atracorioum (0.5mg/kg) for induction and propofol (100-200 μg/kg) for maintenance. Then pain score (vas score), heart rate, blood pressure was recorded in 2nd, 6th, 12th and 24th hours after tracheal extubation. Pain was treated with morphin 0.1 mg /kg in patients with vas score >4. Total Opioid consumption was recorded for 24hours.

Results: Mean painless time in celexib group was higher than placebo group {12.7±9.8 to 5.38±8.3 (p=0.04)} and mean pain score of 2nd hour in the celexib group was lower than placebo {2.2±2.2 to 5.7±3.5 (p=0.003)}. The mean opioid used in celexib group was lower than placebo group {5.33±6.1 to 11.15±7.1 (p=0.02)}. But difference in mean of HR and BP between two groups wasn’t significant.

Conclusion: Preemptive clexib to be able to reduce pain score and consumption of opioid after hernirrhaphy.