Comparison of parecoxib and proparacetamol in endoscopic nasal surgery patients.
OBJECTIVE
The aim of the study was to compare the efficacy of parecoxib for postoperative analgesia after endoscopic turbinate and sinus surgery with the prodrug of acetaminophen, proparacetamol.


METHODS
Fifty American Society of Anesthesiology (ASA) physical status I-II patients, receiving functional endoscopic sinus surgery (FESS) and endoscopic turbinectomy, were investigated in a prospective, randomized, double-blind manner. After local infiltration with 1% mepivacaine, patients were randomly allocated to receive intravenous (i.v.) administration of either 40 mg of parecoxib (n=25) or 2 g of proparacetamol (n=25) 15 min before discontinuation of total i.v. anaesthesia with propofol and remifentanil. A blinded observer recorded the incidence and severity of pain at admission to the post anaesthesia care unit (PACU) at 10, 20, and 30 min after PACU admission, and every 1 h thereafter for the first 6 postoperative h.


RESULTS
The area under the curve of VAS (AUC(VAS)) calculated during the study period was 669 (28-1901) cm x min in the proparacetamol group and 635 (26-1413) cm x min in the parecoxib group (p=0.34). Rescue morphine analgesia was required by 14 patients (56%) in the proparacetamol group and 12 patients (48%) in the parecoxib (p >or= 0.05), while mean morphine consumption was 5-3.5mg and 5-2.0 mg in the proparacetamol groups and parecoxib, respectively (p >or= 0.05). No differences in the incidence of side effects were recorded between the 2 groups. Patient satisfaction was similarly high in both groups, and all patients were uneventfully discharged 24 h after surgery.


CONCLUSIONS
In patients undergoing endoscopic nasal surgery, prior infiltration with local anaesthetics, parecoxib administered before discontinuing general anaesthetic, is not superior to proparacetamol in treating early postoperative pain.
Leykin
Yigal
Y
Department of Anaesthesia and Intensive Care, Santa Maria degli Angeli Hospital, Via Montereale 24 33170 Pordenone, Italy. yigal.leykin@aopn.fvg.it
Casati
Andrea
A
Rapotec
Alessandro
A
Dalsasso
Massimiliano
M
Barzan
Luigi
L
Fanelli
Guido
G
Pellis
Tommaso
T
D000082:Acetaminophen / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007555:Isoxazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000601:surgery; D010149:Postoperative Pain / Q000188:drug therapy*; D011355:Prodrugs / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012852:Sinusitis / Q000601:surgery; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D016861:Cyclooxygenase Inhibitors; D007555:Isoxazoles; D011355:Prodrugs; D000082:Acetaminophen; C409945:parecoxib