Yonsei Med J.  2008 Jun;49(3):383-388. 10.3349/ymj.2008.49.3.383.

Comparison of Parecoxib and Proparacetamol in Endoscopic Nasal Surgery Patients

• Leykin Y
• Casati A
• Rapotec A
• Dalsasso M
• Barzan L
• Fanelli G
• Pellis T

• KMID: 724252
• DOI: http://doi.org/10.3349/ymj.2008.49.3.383

Abstract

PURPOSE
The aim of the study was to compare the efficacy of parecoxib for postoperative analgesia after endoscopic turbinate and sinus surgery with the prodrug of acetaminophen, proparacetamol. MATERIALS AND METHODS: Fifty American Society of Anesthesiology (ASA) physical status I-II patients, receiving functional endoscopic sinus surgery (FESS) and endoscopic turbinectomy, were investigated in a prospective, randomized, double-blind manner. After local infiltration with 1% mepivacaine, patients were randomly allocated to receive intravenous (IV) administration of either 40mg of parecoxib (n=25) or 2g of proparacetamol (n=25) 15 min before discontinuation of total IV anaesthesia with propofol and remifentanil. A blinded observer recorded the incidence and severity of pain at admission to the post anaesthesia care unit (PACU) at 10, 20, and 30 min after PACU admission, and every 1 h thereafter for the first 6 postoperative h. RESULTS: The area under the curve of VAS (AUC(VAS)) calculated during the study period was 669 (28-1901) cm·min in the proparacetamol group and 635 (26-1413) cm·min in the parecoxib group (p=0.34). Rescue morphine analgesia was required by 14 patients (56%) in the proparacetamol group and 12 patients (48%) in the parecoxib (p> or=0.05), while mean morphine consumption was 5-3.5mg and 5-2.0mg in the proparacetamol groups and parecoxib, respectively (p> or=0.05). No differences in the incidence of side effects were recorded between the 2 groups. Patient satisfaction was similarly high in both groups, and all patients were uneventfully discharged 24h after surgery. CONCLUSION: In patients undergoing endoscopic nasal surgery, prior infiltration with local anaesthetics, parecoxib administered before discontinuing general anaesthetic, is not superior to proparacetamol in treating early postoperative pain.

Keyword

Postoperative pain; parecoxib; proparacetamol; analgesia; nasal surgery

MeSH Terms

Acetaminophen/administration & dosage/analogs & derivatives/*therapeutic use
Adult
Analgesics, Non-Narcotic/administration & dosage/therapeutic use
Cyclooxygenase Inhibitors/administration & dosage/therapeutic use
Double-Blind Method
Endoscopy/methods
Female
Humans
Infusions, Intravenous
Injections, Intravenous
Isoxazoles/administration & dosage/*therapeutic use
Male
Middle Aged
Nasal Polyps/surgery
Pain, Postoperative/*drug therapy
Prodrugs/administration & dosage/*therapeutic use
Prospective Studies
Sinusitis/surgery
Treatment Outcome

Figure

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  Fig. 1 Mean postoperative VAS measured at PACU admission for the first 6 h.

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