Effect of parecoxib on remifentanil-induced hyperalgesia after ambulatory surgery

doi:10.5246/jcps.2013.04.053

Abstract

Abstract:

In previous human studies, pretreatment with parecoxib can effectively relieve hyperalgesia after short-term infusion of remifentanil. In this study, we aim to investigate the effect of parecoxib on hyperalgesia after short-term infusion of remifentanil in clinical practice. Totally, 120 patients who underwent ambulatory surgery were randomly divided into four groups. All patients received either parecoxib (40 mg) or normal saline (as placebo) 30 min before induction of anesthesia. Group A (placebo + propofol) and Group B (parecoxib + propofol) received only propofol for anesthesia, while Group C (placebo + propofol + remifentanil) and Group D (parecoxib + propofol + remifentanil) received both propofol and remifentanil for anesthesia. Visual analogue score (VAS) was used to evaluate pain score at various time points, including the time of birth date recollection and 30, 60, 90, 120, 180, 240, and 300 min after surgery, respectively. During the phase from discontinuation of anesthesia to 240 min after surgery, there is significant difference in the severity of pain among four groups with the order of: Group B <Group A <Group D <Group C (P<0.001). Compared with patients in Groups A and B, patients in Group C suffered significantly higher pain score. After administration of parecoxib, patients in Groups B and D experienced similar low pain score with comparison to Groups A and C (P<0.001). Patients in Groups B and D experienced shorter recovery time to eye opening on verbal command and recollection of birth date among the four groups (P<0.001). Groups B and D also had significantly improved satisfaction of pain management (P<0.001). In conclusion, short-term infusion of remifentanil can induce significant hyperalgesia in clinical practice, while pretreatment with parecoxib at 40 mg is effective in relieving such remifentani-induced hyperalgesia. In addition, we also found that pretreatment with parecoxib could significantly improve patients' satisfaction of pain management.

Key words: Parecoxib, Short-term infusion, Remifentanil, Hyperalgesia

CLC Number:

R969.3

Supporting:

Dongliang Mu, Dongxin Wang^*, Yuan Qu, Chunjing Li . Effect of parecoxib on remifentanil-induced hyperalgesia after ambulatory surgery[J]. , DOI: 10.5246/jcps.2013.04.053.

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