title: Pain control in laparoscopic gynecologic surgery with/without preoperative (preemptive) parecoxib sodium injection: a randomized study.
abstract: OBJECTIVE
  To determine the effectiveness of preoperative parecoxib sodium injection for pain relief after laparoscopic gynecologic surgery.
  
  
  METHODS
  A prospective double-blind, randomized study was conducted in 268 patients who underwent laparoscopic gynecologic surgery at Vajira Hospital between November 1, 2010 and March 31, 2011. The patients were randomly allocated into two groups to receive either single intravenous 40 mg parecoxib (treatment group; n = 133) or normal saline (control group; n = 135) 30 min before surgery. The degree of postoperative pain was assessed every 2 h in the first 8 h postoperation, then every 4 h until completion of 24 h by using a verbal rating scale. Total consumption of meperidine over a 24-h period and the adverse events relevant to parecoxib sodium were also recorded.
  
  
  RESULTS
  Mean pain scores at all measured times in the treatment group were insignificantly lower than those in the control group (p = 0.106). The mean 24-h postoperative meperidine consumption in the treatment group was significantly lower compared to that in the control group (26.3 +/- 28.1 mg and 39.1 +/- 34.6 mg, respectively, p = 0.001). The proportion of patients requiring meperidine in the treatment group was significantly lower than that in the control group (58.6% and 70.3%, respectively, p = 0. 045). No serious adverse events were observed in both groups.
  
  
  CONCLUSIONS
  Preoperative parecoxib sodium significantly reduced postoperative meperidine requirement and consumption, while insignificantly declined the pain scores. Serious adverse events were not encountered
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis, Bangkok, Thailand. rsarwinee@yahoo.com
authors.forename: Sarwinee
authors.initials: S
authors.lastname: Ratchanon
authors.forename: Chadakarn
authors.initials: C
authors.lastname: Phaloprakarn
authors.forename: Khanitta
authors.initials: K
authors.lastname: Traipak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007275:Injections, Intravenous; D007555:Isoxazoles / Q000008:administration & dosage*; D010535:Laparoscopy; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D019990:Perioperative Care; D011446:Prospective Studies; D013785:Thailand; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D016861:Cyclooxygenase Inhibitors; D007555:Isoxazoles; D008614:Meperidine; C409945:parecoxib