Perioperative celecoxib administration for pain management after total knee arthroplasty - A randomized, controlled study

Yu Min Huang, Chiu Meng Wang, Chen Ti Wang, Wei Peng Lin, Lih Ching Horng, Ching Chuan Jiang

研究成果: 雜誌貢獻文章

87 引文 (Scopus)

摘要

Background. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty. Methods. This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA) morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS) pain scores, active range of motion (ROM), total opioid use and postoperative nausea/vomiting were analyzed. Results. Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03) and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02) after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8°± 17.3°vs. 25.8°± 11.5°, p = 0.01 (day 1); 60.7°± 18.1°vs. 45.0°± 17.3°, p = 0.004 (day 2); 77.7°± 15.1°vs. 64.3°± 16.9°, p = 0.004 (day 3)]. Opioid requirements decreased about 40% (p = 0.03) in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43% in control group to 28% in celecoxib group, this was not significant (p = 0.57). There were no differences in blood loss (intra- and postoperative) between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions. Conclusion. Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid consumption, and active ROM in the first three days after total knee arthroplasty, without increasing the risks of bleeding. Trial registration. Clinicaltrials.gov NCT00598234.

原文英語
文章編號77
期刊BMC Musculoskeletal Disorders
9
DOIs
出版狀態已發佈 - 七月 7 2008

指紋

Celecoxib
Knee Replacement Arthroplasties
Pain Management
Articular Range of Motion
Opioid Analgesics
Postoperative Pain
Pain Measurement
Morphine
Analgesics
Postoperative Hemorrhage
Postoperative Nausea and Vomiting
Control Groups

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Perioperative celecoxib administration for pain management after total knee arthroplasty - A randomized, controlled study. / Huang, Yu Min; Wang, Chiu Meng; Wang, Chen Ti; Lin, Wei Peng; Horng, Lih Ching; Jiang, Ching Chuan.

於: BMC Musculoskeletal Disorders, 卷 9, 77, 07.07.2008.

研究成果: 雜誌貢獻文章

Huang, Yu Min ; Wang, Chiu Meng ; Wang, Chen Ti ; Lin, Wei Peng ; Horng, Lih Ching ; Jiang, Ching Chuan. / Perioperative celecoxib administration for pain management after total knee arthroplasty - A randomized, controlled study. 於: BMC Musculoskeletal Disorders. 2008 ; 卷 9.
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abstract = "Background. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty. Methods. This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA) morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS) pain scores, active range of motion (ROM), total opioid use and postoperative nausea/vomiting were analyzed. Results. Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03) and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02) after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8°± 17.3°vs. 25.8°± 11.5°, p = 0.01 (day 1); 60.7°± 18.1°vs. 45.0°± 17.3°, p = 0.004 (day 2); 77.7°± 15.1°vs. 64.3°± 16.9°, p = 0.004 (day 3)]. Opioid requirements decreased about 40{\%} (p = 0.03) in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43{\%} in control group to 28{\%} in celecoxib group, this was not significant (p = 0.57). There were no differences in blood loss (intra- and postoperative) between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions. Conclusion. Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid consumption, and active ROM in the first three days after total knee arthroplasty, without increasing the risks of bleeding. Trial registration. Clinicaltrials.gov NCT00598234.",
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T1 - Perioperative celecoxib administration for pain management after total knee arthroplasty - A randomized, controlled study

AU - Huang, Yu Min

AU - Wang, Chiu Meng

AU - Wang, Chen Ti

AU - Lin, Wei Peng

AU - Horng, Lih Ching

AU - Jiang, Ching Chuan

PY - 2008/7/7

Y1 - 2008/7/7

N2 - Background. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty. Methods. This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA) morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS) pain scores, active range of motion (ROM), total opioid use and postoperative nausea/vomiting were analyzed. Results. Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03) and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02) after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8°± 17.3°vs. 25.8°± 11.5°, p = 0.01 (day 1); 60.7°± 18.1°vs. 45.0°± 17.3°, p = 0.004 (day 2); 77.7°± 15.1°vs. 64.3°± 16.9°, p = 0.004 (day 3)]. Opioid requirements decreased about 40% (p = 0.03) in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43% in control group to 28% in celecoxib group, this was not significant (p = 0.57). There were no differences in blood loss (intra- and postoperative) between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions. Conclusion. Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid consumption, and active ROM in the first three days after total knee arthroplasty, without increasing the risks of bleeding. Trial registration. Clinicaltrials.gov NCT00598234.

AB - Background. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty. Methods. This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA) morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS) pain scores, active range of motion (ROM), total opioid use and postoperative nausea/vomiting were analyzed. Results. Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03) and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02) after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8°± 17.3°vs. 25.8°± 11.5°, p = 0.01 (day 1); 60.7°± 18.1°vs. 45.0°± 17.3°, p = 0.004 (day 2); 77.7°± 15.1°vs. 64.3°± 16.9°, p = 0.004 (day 3)]. Opioid requirements decreased about 40% (p = 0.03) in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43% in control group to 28% in celecoxib group, this was not significant (p = 0.57). There were no differences in blood loss (intra- and postoperative) between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions. Conclusion. Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid consumption, and active ROM in the first three days after total knee arthroplasty, without increasing the risks of bleeding. Trial registration. Clinicaltrials.gov NCT00598234.

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