Effect of celecoxib combined with thoracic epidural analgesia on pain after thoracotomy.
BACKGROUND
Thoracotomy results in severe postoperative pain potentially leading to chronic pain. We investigated the potential benefits of oral celecoxib on postoperative analgesia combined with thoracic epidural analgesia (TEA).


METHODS
Forty patients undergoing thoracotomy were included in this prospective, randomized, double-blind, placebo-controlled study. General anaesthesia was standardized. Patient-controlled epidural analgesia (T4-T5) was used during 48 h after surgery (ropivacaine 2 mg ml(-1) with sufentanil 0.5 microg ml(-1)). Patients were allocated to receive oral celecoxib or placebo from the evening before surgery until 48 h after operation. Postoperative pain scores, respiratory function, and morbidity were compared between the two groups.


RESULTS
Postoperative pain scores at rest (P=0.026) and during coughing (P=0.021) were lower and patient satisfaction was greater (P=0.0033) in the celecoxib group. Consumption of the local anaesthetic solution was comparable between groups. Postoperative restrictive pulmonary syndrome and morbidity were comparable between groups.


CONCLUSIONS
Celecoxib improves postoperative analgesia provided by TEA after thoracotomy.
Senard
M
M
Department of Anaesthesia and Intensive Care Medicine, Thoracic and Vascular Surgery, CHU de Liège, University of Liège, Domaine du Sart-Tilman, Liege, Belgium.
Deflandre
E P
EP
Ledoux
D
D
Roediger
L
L
Hubert
B M
BM
Radermecker
M
M
Libbrecht
D
D
Joris
J L
JL
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods*; D000068579:Celecoxib; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011720:Pyrazoles / Q000008:administration & dosage*; D013449:Sulfonamides / Q000008:administration & dosage*; D013908:Thoracotomy / Q000009:adverse effects*; D014797:Vital Capacity / Q000187:drug effects; D055815:Young Adult
D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib