Effects of parecoxib on postoperative pain and opioid-related symptoms following gynecologic surgery

• Main Authors: Parsons B, Zhu Q, Xie L, Li C, Cheung R
• Format: Article
• Language: English
• Published: Dove Medical Press 2016-11-01
• Series: Journal of Pain Research
• Subjects: Parecoxib; Postoperative pain; Gynecologic surgery
• Online Access: https://www.dovepress.com/effects-of-parecoxib-on-postoperative-pain-and-opioid-related-symptoms-peer-reviewed-article-JPR

Bruce Parsons,1 Qijiang Zhu,2 Li Xie,3 Chunming Li,1 Raymond Cheung1 1Pfizer Inc, New York, NY, USA; 281st Hospital of Chinese People’s Liberation Army, Nanjing, People’s Republic of China; 3Pfizer Investment Co., Ltd, Beijing, People’s Republic of China Objective: To examine the analgesic and opioid-sparing effects of parecoxib following major gynecologic surgery.Methods: This is a large subset analysis of patients from a multicenter, randomized, double-blind, placebo-controlled study of parecoxib/valdecoxib (PAR/VAL) for postoperative pain. Pain severity, pain interference with function, opioid use, occurrence of opioid-related symptoms, and Patient/Physician Global Evaluation of Study Medication were compared between placebo and PAR/VAL treatment groups in the days following surgery. Results: Pain scores were reduced in the PAR/VAL group (n=98), relative to placebo (n=97), on Day 2 (−21%, P<0.001) and Day 3 (−23%, P=0.004). Pain interference with function scores were also significantly lower in the PAR/VAL group, compared with placebo, on Day 2 (−29%, P<0.001) and Day 3 (−28%, P=0.013). Consumption of supplemental morphine was significantly lower in the PAR/VAL group relative to placebo at 24 hours (−37%, P=0.010) and trended lower at 48 (−28%) and 72 hours (−26%). Patients in the PAR/VAL group also had a reduced risk of experiencing specific opioid-related symptoms, including “inability to concentrate” (relative risk =0.53) and “nausea” (relative risk =0.60) on Day 2. Both Patient and Physician Global Evaluation of Study Medication scores were better in the PAR/VAL group than in the placebo group. Conclusion: The current study adds support for the use of parecoxib in patients following major gynecologic surgery. Keywords: parecoxib, postoperative pain, gynecologic surgery