Τόμος 25 (2007) – Τεύχος 1 – Άρθρο 2 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 25 (2007) – Issue 1– Article 2 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

Επίδραση της Ενδοφλέβιας Παρεκοξίμπης στις Ανάγκες σε Οπιοειδή στα Πλαίσια Πολυπαραγοντικής Μετεγχειρητικής Αναλγησίας σε Ασθενείς που Υποβλήθηκαν σε Θωρακοτομή

Ιntravenous Parecoxib during Post­operative Multimodal Analgesia after Thoracotomy: Impact on Opioid Needs and Postoperative Complica­tions

Ελληνικά – Greek

Στατιστική Μελέτη

Statistical Study

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Selective COX-2, especially intravenous administered parecoxib, is considered as suitable drug for the management of postoperative pain, due to anti-platelet sparing action. Nevertheless, there were no studies in the literature evaluating their potential bene­ficial role in major operations. Goal of the present study was the investigation of the impact of periopera­tively-administered parecoxib during multimodal anal­gesic technique following thoracotomies. Forty pa­tients, aged 13-73, underwent thoracotomy under the standard anesthetic regimen. Afterwards, patients were assigned into two groups to receive either two doses of 40 mg parecoxib i.v. (group A) or normal sa­line (group B). The first dose was administered one hour after commencement of the procedure, while the second dose was after operation completion. All pa­tients had access to intravenous morphine through patient-controlled analgesia pump after recovery from anesthesia. Patients were evaluated during postopera­tive period for pain intensity. Postoperative pain was assessed using 0-10 visual analog scale. Furthermore, total morphine consumption and major and minor complications were also studied through the first 48 hours postoperatively. Differences between groups were compared using t-test, chi squere test, ANOVA and Kruskal Wallis tests. Level of significance was set at a<0.05. Groups were comparable regarding demo­graphic data and frequency of postoperative complica­tions. VAS scale was significant lower at group A for the time periods t=12h (p=0,015) and t=24h (p=0,010), while differences observed at time period στιγμές t=4h and t=48h were not significant (p>0,05). Regarding morphine consumption over time, statistical analysis revealed significant differences between groups for the time periods t=24h (p=0,045) and t=48h (p=0,009). In conclusion, parecoxib administered intravenously seemed to contribute to pain control improvement and lower opioid consumption during multimodal analgesic technique after thoracotomy. Furthermore, parecoxib administration didn’t cause severe complications. Fur­ther studies are necessary to confirm its safety for postoperative pain management following major op­erations.