[Postoperative analgesia after laparoscopic cholecystectomy: comparison of the preoperative administration of celecoxib with paracetamol?]

Tunis Med. 2008 Oct;86(10):869-73.
[Article in French]

Abstract

Objective: The goal of this study was to evaluate the preventive analgesic effectiveness of paracetamol and celecoxib in laparoscopic cholecystectomy.

Methods: Randomized prospective study was undertaken, 75 patients of class ASA I and II were included, divided into three groups: P (Paracetamol 1000 mg), C (Celecoxib 200 mg) given orally one hour before induction and group T (without preoperative analgesia). The VAS at rest and effort was noted on arrival in the recovery room then with regular intervals (T(30mn) to T(h24). A morphine titration was carried out during the first 12 postoperative hours. Hemodynamic parameters, Ramsay score and the adverse effects were noted.

Results: The three groups were comparable for the demographic data, the duration of anesthesia and peroperative morphine consumption. The evolution of VAS scores shows a significant difference between the groups P and T with the effort of cough at t24h (p = 0.04), and between the groups C and T at postoperative T 4h (p = 0.016). In our study the group C consumed to a significant degree less morphine 5.44 +/- 3.00 Mg against 7.83 +/- 4.00 Mg for the group P (p < 0.03) and 8.04 +/- 3.00 Mg for the group T (p < 0.008).

Conclusion: The administration of 200 Mg of celecoxib in the preoperative period of a laparoscopic cholecystectomy allows a significant decrease in morphine consumption in the postoperative period and a reduction in the scores of the VAS at rest and at the effort of cough compared to the groups which received only one placebo or paracetamol.

Publication types

  • Comparative Study
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / therapeutic use*
  • Adolescent
  • Adult
  • Aged
  • Analgesics, Non-Narcotic / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Celecoxib
  • Cholecystectomy, Laparoscopic / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology*
  • Prospective Studies
  • Pyrazoles / therapeutic use*
  • Sulfonamides / therapeutic use*
  • Young Adult

Substances

  • Analgesics, Non-Narcotic
  • Anti-Inflammatory Agents, Non-Steroidal
  • Pyrazoles
  • Sulfonamides
  • Acetaminophen
  • Celecoxib