Improving the analgesic efficacy of intrathecal morphine with parecoxib after total abdominal hysterectomy.
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.
Niruthisard
Supranee
S
Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. drsupranee@hotmail.com
Werawataganon
Thewarug
T
Bunburaphong
Pavena
P
Ussawanophakiat
Montson
M
Wongsakornchaikul
Chuthayuth
C
Toleb
Kusonsi
K
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
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D016861:Cyclooxygenase Inhibitors; D007555:Isoxazoles; D009020:Morphine; C409945:parecoxib; D002045:Bupivacaine