Preoperative administration of rofecoxib versus ketoprofen for pain relief after tonsillectomy.
OBJECTIVE
We evaluated the analgesic efficacy and the opioid-sparing effect of oral rofecoxib compared with intramuscular (IM) ketoprofen in tonsillectomy.


METHODS
Seventy-seven adult patients were randomized into 2 groups: group R (n = 39), which received a single oral preoperative dose of rofecoxib 50 mg, and group K (n = 38), which received 2 IM doses of ketoprofen 100 mg (before surgery and after 12 hours). In both groups, additional IM meperidine hydrochloride 1 mg/kg was given. All patients received general anesthesia. A pain score (visual analog scale, 0 to 100) was assessed both at rest and during swallowing at 30 minutes and at 4, 8, 12, 16, and 24 hours after operation. If the pain score exceeded 40, patients were given meperidine as rescue analgesia.


RESULTS
The pain scores during rest and swallowing in group R were significantly lower (p < .05) than those of group K at 4, 8, and 12 hours after operation. Meperidine was given as rescue medication in significantly more patients of group K (76%) than of group R (38%; p < .05).


CONCLUSIONS
Oral premedication with rofecoxib seems to be more effective than use of ketoprofen in decreasing postoperative pain and the need for opioid rescue medication after elective tonsillectomy. Both drugs seem to be relatively safe as far as postoperative bleeding is concerned.
Louizos
Antonios A
AA
Department of Anesthesiology, Hippocration General Hospital, Athens, Greece.
Pandazi
Ageliki B
AB
Koraka
Christina P
CP
Davilis
Dimitrios I
DI
Georgiou
Loucas G
LG
D000284:Administration, Oral; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D007660:Ketoprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D007783:Lactones / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011300:Preoperative Care; D013450:Sulfones / Q000008:administration & dosage / Q000627:therapeutic use*; D014068:Tonsillectomy; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib; D007660:Ketoprofen