Pain Relief by Parecoxib for Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Yu Cih Lin, Chien Yu Chen, Yuan Mei Liao, Pi Chu Lin, Chuen Chau Chang

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: The aim of this meta-analysis is to verify the effectiveness of postoperative pain relief by perioperative parecoxib, a selective intravenous cyclooxygenase-2 (COX-2) inhibitor, for patients receiving laparoscopic cholecystectomy (LC) surgery. METHODS: Electronic databases were searched for the randomized controlled trials (RCTs) to evaluate the effectiveness of pain relief by parecoxib or placebo for patients receiving LC surgery. The primary outcomes was the pain score evaluation using visual analogue scale (VAS). The secondary outcomes were the opioids consumption or analgesic supplement requirement and incidence of any adverse events such as dizziness, nausea and vomiting. RESULTS: Ten trials with 916 patients were included. Perioperative parecoxib significantly reduced postoperative pain score with rest at post-anaesthesia care unit (PACU; mean difference [MD] = -0.58, 95% confi dence interval [CI] = -1.04 to -0.12, p = 0.01) after LC. Postoperative opioid requirement or analgesic supplement for rescue of pain was also effectively reduced (relative risk [RR] = 0.47, 95% CI = 0.33 to 0.66, p < 0.0001). The incidence of side effects such as postoperative nausea and vomiting (PONV) was unaffected (RR = 0.83, 95% CI = 0.63 to 1.10, p = 0.20). CONCLUSION: Perioperative intravenous parecoxib could effectively provide pain relief and reduced postoperative morphine consumption or rescue analgesics for LC surgery without causing additional adverse concerns.

Original languageEnglish
Pages (from-to)92-114
Number of pages23
JournalAsian Journal of Anesthesiology
Volume56
Issue number3
DOIs
Publication statusPublished - Sep 1 2018

Keywords

  • COX-2 inhibitor
  • laparoscopic cholecystectomy
  • meta-analysis
  • pain relief
  • parecoxib

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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