title: Analgesic effects of rofecoxib in ear-nose-throat surgery.
abstract: In this study we evaluated the analgesic efficacy and the opioid-sparing effect of rofecoxib in ear-nose-throat surgery patients. Patients undergoing nasal septal or sinus surgery were randomized to receive either oral placebo or rofecoxib 50 mg 1 h before surgery. All patients received propofol 0.8 mg/kg, fentanyl 1 microg/kg, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted to maintain sedation at a 2-3 level on the Ramsey scale. Additional fentanyl 0.5-1 microg/kg was administered at the patient's request or if the verbal rating scale score was >4. Patient sedation and pain scores were obtained at 5, 15, 30 45, and 60 min during surgery and 30 min and 2, 4, 6, 12, and 24 h after completion of the procedure. During the postoperative period, diclofenac 75 mg IM was administered for analgesia at the patient's request or if the visual analog scale (VAS) rating for pain was more than 4. VAS pain scores, intraoperative fentanyl, and postoperative diclofenac requirements were significantly smaller in the rofecoxib group compared with the placebo group (P < 0.001). The times to first analgesic request were also significantly less in the rofecoxib group. We conclude that the preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.
  
  
  CONCLUSIONS
  The aim of this study was to evaluate the analgesic efficacy and opioid-sparing effect of rofecoxib, a new selective cyclooxygenase-2 inhibitor drug, in ear-nose-throat surgery patients. Preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.
authors.affiliation: Department of Anaesthesiology, Trakya University Medical Faculty, 22030 Edirne, Turkey. alparslanturan@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Turan
authors.forename: S
authors.initials: S
authors.lastname: Emet
authors.forename: B
authors.initials: B
authors.lastname: Karamanlioğlu
authors.forename: D
authors.initials: D
authors.lastname: Memiş
authors.forename: N
authors.initials: N
authors.lastname: Turan
authors.forename: Z
authors.initials: Z
authors.lastname: Pamukcu
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism*; D007783:Lactones / Q000627:therapeutic use*; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008565:Membrane Proteins; D013517:Otorhinolaryngologic Surgical Procedures; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D013450:Sulfones
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D007783:Lactones; D008565:Membrane Proteins; D013450:Sulfones; C116926:rofecoxib; D008012:Lidocaine; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D010100:Oxygen; D005283:Fentanyl