Postoperative analgesia with parecoxib, acetaminophen, and the combination of both: a randomized, double-blind, placebo-controlled trial in patients undergoing thyroid surgery.
BACKGROUND
We assessed the analgesic efficacy of parecoxib, acetaminophen, and the combination of both compared with placebo in patients undergoing elective thyroid or parathyroid surgery.


METHODS
We randomized 140 patients to receive one of the following i.v. treatments using a double-blinded double-dummy technique: placebo, 80 mg 24 h(-1) parecoxib, 5 g 24 h(-1) acetaminophen, or 80 mg parecoxib plus 5 g acetaminophen. We provided rescue analgesia with piritramide delivered by a patient-controlled analgesia device. We measured opioid consumption and pain intensity over 24 h after operation.


RESULTS
Patient characteristic data, anaesthetic, and surgical characteristics of the patients in the four groups were similar. Parecoxib, acetaminophen, and the combination significantly reduced opioid requirements during 24 h after surgery [mean (sd) 12.5 (10.9) mg for parecoxib, 14.2 (12.3) mg for acetaminophen, and 11.9 (10.7) mg for combination] compared with placebo [23.5 (15.3) mg, P<0.05]. However, the combination of parecoxib and acetaminophen did not have any advantage over individual drugs in terms of opioid consumption in our trial (P>0.05).


CONCLUSIONS
Parecoxib and acetaminophen effectively reduce postoperative opioid requirements after thyroid or parathyroid surgery. The combination of these drugs is not associated with a further reduction in opioid consumption.
Gehling
M
M
Department of Anaesthesiology and Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany. gehling@klinikum-kassel.de
Arndt
C
C
Eberhart
L H J
LH
Koch
T
T
Krüger
T
T
Wulf
H
H
D000082:Acetaminophen / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled / Q000379:methods; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D010280:Parathyroid Glands / Q000601:surgery; D010892:Pirinitramide / Q000008:administration & dosage; D011182:Postoperative Care / Q000379:methods; D013961:Thyroid Gland / Q000601:surgery*; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; D000082:Acetaminophen; D010892:Pirinitramide; C409945:parecoxib