title: Retrospective evaluation of inpatient celecoxib use after total hip and knee arthroplasty at a Veterans Affairs Medical Center.
abstract: A retrospective cohort study (1.5 years) was performed to investigate the efficacy of celecoxib vs non-celecoxib use in patient who underwent total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study time frame encompassed a pre and post period of a local policy decision opening access to short-term celecoxib use after TKA/THA. Primary end point was the amount of opioid use during their inpatient stay postprocedure. The TKA (n = 81) and THA (n = 60) groups were analyzed independently. Both celecoxib groups used significantly less opioids during their inpatient stay vs noncelecoxib groups, given in oral morphine milligram equivalents (TKA: 203 vs 337 mg, P = .002; THA: 214 vs 336 mg, P = .005). Other secondary outcome measures showed that the celecoxib groups also reported reduction in pain scores, total as needed (PRN) opioid doses, PRN opioid doses per day, average dose of PRN opioids, total PRN opioids, use of intravenous opioids, and rehabilitation facility admissions (in the TKA group only). Linear regression analysis showed a statistically significant inverse relationship between opioid consumption and age. Short-term celecoxib use after TKA/THA may lead to a reduction in overall opioid use and improved pain scores; however, further studies will be required to validate the results of this study.
authors.affiliation: Pharmacoeconomics and Formulary Management, Veterans Affairs San Diego Healthcare System, San Diego, California 92161, USA.
authors.forename: Rashid
authors.initials: R
authors.lastname: Kazerooni
authors.forename: Mark
authors.initials: M
authors.lastname: Bounthavong
authors.forename: Josephine N
authors.initials: JN
authors.lastname: Tran
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Boggie
authors.forename: Robert Scott
authors.initials: RS
authors.lastname: Meyer
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D000068579:Celecoxib; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D011720:Pyrazoles / Q000627:therapeutic use*; D012044:Regression Analysis; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D011720:Pyrazoles; D013449:Sulfonamides; D009020:Morphine; D000068579:Celecoxib