title: Sevoflurane requirement during elective ankle day surgery: the effects of etirocoxib premedication, a prospective randomised study.
abstract: BACKGROUND
  Anti-inflammatory drugs, NSAIDs, have become an important part of the pain management in day surgery. The aim of the present study was to evaluate the effect of Coxib premedication on the intra-operative anaesthetic requirements in patients undergoing elective ankle surgery in general anaesthesia.
  
  
  METHODS
  Prospective, randomized study of the intra-operative anaesthetic-sparing effects of etoricoxib premedication as compared to no NSAID preoperatively.
  
  
  METHODS
  The intra-operative requirement of sevoflurane was studied in forty-four ASA 1-2 patients undergoing elective ankle day surgical in balanced general anaesthesia. Primary study endpoint was end-tidal sevoflurane concentration to maintain Cerebral State Index of 40-50 during surgery.
  
  
  RESULTS
  All anaesthesia and surgery was uneventful, no complications or adverse events were noticed. The mean end-tidal sevoflurane concentration intra-operatively was 1.25 (SD 0.2) and 0.91 (SD 0.2) for the pre and post-operative administered group of patients respectively (p < 0.0001). No other intra-operative differences could be noted. Emergence and recovery was rapid and no difference was noticed in time to discharge-eligible mean 52 minutes in both groups studied. In all 6 patients, 5 in the group receiving etoricoxib post-operatively, after surgery, and one in the pre-operative group required rescue analgesia before discharge from hospital. No difference was seen in pain or need for rescue analgesia, nausea or patients satisfaction during the first 24 postoperative hours.
  
  
  CONCLUSIONS
  Coxib premedication before elective day surgery has an anaesthetic sparing potential.
authors.affiliation: Karolinska Institutet, Institution for Physiology & Pharmacology, Department of Anaesthesia & Intensive Care, Foot & Ankle Surgical Centre, Stockholm, Sweden.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Turan
authors.forename: Anette
authors.initials: A
authors.lastname: Hein
authors.forename: Eva
authors.initials: E
authors.lastname: Jacobson
authors.forename: Jan G
authors.initials: JG
authors.lastname: Jakobsson
references.citation: Br J Anaesth. 1999 Apr;82(4):561-5
references.pmid: 10472223
references.citation: Anesth Analg. 2002 Nov;95(5):1308-11, table of contents
references.pmid: 12401617
references.citation: Acta Anaesthesiol Scand. 2005 Jul;49(6):750-3
references.pmid: 15954953
references.citation: Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003843
references.pmid: 17943802
references.citation: Br J Anaesth. 1999 Jun;82(6):827-30
references.pmid: 10562773
references.citation: Anesth Analg. 2006 Feb;102(2):418-25
references.pmid: 16428536
references.citation: Eur J Anaesthesiol. 2006 Mar;23(3):208-12
references.pmid: 16430792
references.citation: Acta Anaesthesiol Sin. 2002 Mar;40(1):9-12
references.pmid: 11989050
references.citation: J Clin Anesth. 1995 Sep;7(6):481-5
references.pmid: 8534465
references.citation: Eur J Anaesthesiol. 2006 Jun;23(6):460-4
references.pmid: 16507194
references.citation: Anesth Analg. 1992 Oct;75(4):566-71
references.pmid: 1388338
references.citation: Anesth Analg. 2007 Mar;104(3):605-10
references.pmid: 17312217
references.citation: Anesth Analg. 2005 Mar;100(3):757-773
references.pmid: 15728066
references.citation: J Orthop Surg Res. 2007 Dec 18;2:26
references.pmid: 18088436
references.citation: Eur J Anaesthesiol. 2002 Jul;19(7):483-6
references.pmid: 12113610
references.citation: Lancet. 2007 Mar 10;369(9564):810-812
references.pmid: 17350437
references.citation: Acta Anaesthesiol Scand. 2002 May;46(5):495-9
references.pmid: 12027841
references.citation: Anesth Analg. 1993 Aug;77(2):205-10
references.pmid: 8346816
references.citation: Can J Anaesth. 2002 May;49(5):458-60
references.pmid: 11983658
references.citation: Anesthesiology. 2001 May;94(5):799-803
references.pmid: 11388531