title: Preoperative intravenous parecoxib reduces length of stay on ambulatory laparoscopic cholecystectomy.
abstract: BACKGROUND
  The complexity of pain after laparoscopic cholecystectomy (LC) needs multi-module analgesia. Opioids are widely used for perioperative pain but associated with numerous adverse effects. We investigated the effect of parecoxib administrated preoperatively and postoperatively for analgesia after ambulatory laparoscopic cholecystectomy.
  
  
  METHODS
  120 patients scheduled for ambulatory LC with general anesthesia were randomly assigned to three groups: group A received 40 mg parecoxib injection 30-45 min before anesthesia induction and 4 ml saline injection when gallbladder was removed; group B received 4 ml saline injection 30-45 min before anesthesia induction and 40 mg parecoxib injection when gallbladder was removed; group C received 4 ml saline injection 30-45 min before anesthesia induction and the time when gallbladder was removed. We recorded the time achieve to modified Aldrete's score > 9 in the post-anesthesia care unit (PACU) and modified Post-Anesthetic Discharge Scoring System (PADSS) > 9 in ambulatory unit. The visual analog scale (VAS) was used to assess the degree of the postoperative pain in the first 24 h, and the numbers of patients who need additional analgesic and postoperative adverse effects were also recorded.
  
  
  RESULTS
  Patients of group A had a shorter length of stay (LOS) in PACU compared to these of group B and group C (32.4 ± 7.2 min vs. 39.1 ± 10.4 min and 42.2 ± 7.6 min, P < 0.05). Patients of group A also had a shorter discharge time compared to these of group B and group C (148.4 ± 39.3 min vs. 187.9 ± 47.7 min and 223.4 ± 52.5 min, P < 0.05). Moreover, patients of group A experienced reduced pain intensity, less postoperative side effect, and less additional analgesic requirement.
  
  
  CONCLUSIONS
  Preoperative administration of parecoxib for postoperative analgesia provided significant effect on reducing PACU length of stay (LOS) and discharge time, and improving patient outcome after ambulatory LC.
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, China.
authors.forename: Li
authors.initials: L
authors.lastname: Shuying
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, China. Electronic address: wangxiao2005_1@hotmail.com.
authors.forename: Wang
authors.initials: W
authors.lastname: Xiao
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Peng
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Tao
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Ziying
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Liang
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D010351:Patient Discharge; D011300:Preoperative Care; D011446:Prospective Studies
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; C409945:parecoxib
keywords: Ambulatory laparoscopic cholecystectomy; Parecoxib; Reduced discharge time; Shorter length of stay