title: Improving the analgesic efficacy of intrathecal morphine with parecoxib after total abdominal hysterectomy.
abstract: BACKGROUND
  The addition of parecoxib to intrathecal morphine and bupivacaine may improve analgesia and reduce morphine's opioid-related side effects.
  
  
  METHODS
  In this prospective, double-blind, randomized, placebo-controlled trial, total abdominal hysterectomy patients received either IV normal saline or parecoxib 40 mg before receiving intrathecal bupivacaine and morphine 0.2 mg. Twelve hours later, this administration was repeated. Patients were observed for 48 h.
  
  
  RESULTS
  The addition of parecoxib to intrathecal morphine and bupivacaine significantly reduced cumulative morphine consumption, Visual Analog Pain scores, and increased patient satisfaction for 24 h postoperatively without an obvious decrease of adverse side effects.
  
  
  CONCLUSIONS
  Perioperative parecoxib enhanced the postoperative analgesia of intrathecal morphine and bupivacaine and improved patient satisfaction.
authors: Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. drsupranee@hotmail.com
authors: Supranee
authors: S
authors: Niruthisard
authors: Thewarug
authors: T
authors: Werawataganon
authors: Pavena
authors: P
authors: Bunburaphong
authors: Montson
authors: M
authors: Ussawanophakiat
authors: Chuthayuth
authors: C
authors: Wongsakornchaikul
authors: Kusonsi
authors: K
authors: Toleb
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007275:Injections, Intravenous; D007278:Injections, Spinal; D007555:Isoxazoles / Q000008:administration & dosage*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D016861:Cyclooxygenase Inhibitors; D007555:Isoxazoles; D009020:Morphine; C409945:parecoxib; D002045:Bupivacaine