title: A single dose of celecoxib 200 mg improves postoperative analgesia provided via patient-controlled epidural technique after caesarean section.
abstract: BACKGROUND
  Celecoxib in a dose of 200 mg is safe for the breast feeding mother, as its milk levels are extremely low. We investigated the efficacy of celecoxib in improving postoperative pain management in parturients under patient-controlled epidural analgesia (PCEA).
  
  
  METHODS
  We studied 64 healthy parturients undergoing elective caesarean section under combined spinal-epidural anesthesia. Postoperative analgesia was performed via PCEA with ropivacaine 0.15% and fentanyl 2 µg/ml (4 ml bolus administration, lock-out 15 min). Patients were randomly allocated to receive either only PCEA (n = 32) or PCEA plus celecoxib 200 mg orally (n = 32). Paracetamol 500 mg was given orally as rescue analgesia. We recorded visual analogue scale (VAS) scores for pain at rest and movement, attempted and given PCEA doses, Bromage scores, level of sensory blockade, rescue doses of paracetamol, maternal side effects during the first 24 h after the PCEA instrumentation, and the overall patient satisfaction.
  
  
  RESULTS
  Fifty-six patients completed the entire protocol. Patient demographics, duration of surgery, side effects, attempted and given PCEA doses, and motor and sensory blockade did not differ between the groups. Significantly lower VAS scores at rest and movement, fewer paracetamol doses (p = 0.039) and increased patient satisfaction (p = 0.001) were found in the celecoxib group compared to controls.
  
  
  CONCLUSIONS
  A single dose of 200 mg of celecoxib effectively improved pain management in parturients with PCEA, limited the need for supplemental analgesics and improved efficacy of analgesia, increasing patient satisfaction.
authors.affiliation: 2 Department of Anaesthesiology, School of Medicine, University of Athens, "Attikon" Hospital, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Matsota
authors.forename: Maria
authors.initials: M
authors.lastname: Nakou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalimeris
authors.forename: Chrisanthi
authors.initials: C
authors.lastname: Batistaki
authors.forename: Angeliki
authors.initials: A
authors.lastname: Pandazi
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
keywords: caesarean section; celecoxib; patient-controlled epidural analgesia; postoperative analgesia