title: A comparison of parecoxib and thoracic epidural analgesia for postoperative analgesia following Nuss procedure.
abstract: BACKGROUND
  The purpose of this study was to compare the results of thoracic epidural analgesia (TEA) and parecoxib in controlling postoperative pain after the Nuss procedure.
  
  
  METHODS
  Between August 2005 and July 2014, 120 adolescents and adults underwent Nuss procedures and received either TEA or parecoxib for postoperative pain control. Demographic data, preoperative preparation times, visual analog scale (VAS) pain scores from postoperative day 1 to day 5, medical costs of pain control, days to Foley catheter removal, days to being able to sit up, days to being able to walk, days of hospital stay, nausea/vomiting scores, and complications related to pain control were compared.
  
  
  RESULTS
  A total of 106 patients received TEA, and 14 received parecoxib. No between-group differences in demographics were observed. Patients in the parecoxib group had shorter preparation times (p<0.001), lower VAS pain scores from postoperative day 2 to day 5 (day 2, p=0.006; day 3, p=0.006; day 4, p<0.001; day 5, p<0.001), shorter hospital stays (p<0.001), lower pain control costs (p<0.001), and lower nausea/vomiting scores (p=0.046).
  
  
  CONCLUSIONS
  For adolescents and adults undergoing the Nuss procedure, parecoxib affords better pain control efficacy, a shorter hospital stay, lower medical pain control costs, and fewer side effects compared with TEA.
authors.affiliation: Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Wendy
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Ming
authors.affiliation: Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Kau
authors.affiliation: Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Chia-Chih
authors.initials: CC
authors.lastname: Liao
authors.affiliation: Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Shih-Chang
authors.initials: SC
authors.lastname: Tsai
authors.affiliation: Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Kit-Man
authors.initials: KM
authors.lastname: Wong
authors.affiliation: Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: Shu-Yam
authors.initials: SY
authors.lastname: Wong
authors.affiliation: Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Linkou, Taiwan. Electronic address: jylai@cgmh.org.tw.
authors.forename: Jin-Yao
authors.initials: JY
authors.lastname: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D007275:Injections, Intravenous; D007555:Isoxazoles / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; C409945:parecoxib
keywords: Adolescent; Nuss procedure; Pain control; Parecoxib; Pectus excavatum; Thoracic epidural analgesia