Transitional Study of Patient-Controlled Analgesia Morphine With Ketorolac to Patient-Controlled Analgesia Morphine With Parecoxib Among Donors in Adult Living Donor Liver Transplantation: A Single-Center Experience.
BACKGROUND
In this study, as our center transitions from using patient-controlled analgesia (PCA) morphine with intravenous (IV) ketorolac to PCA morphine with IV parecoxib, the two regimens are compared in terms of quality of pain control.


METHODS
Post-operative pain management sheets were collected retrospectively among the living donors of liver transplantation during this transitional period. Group parecoxib was given plain PCA morphine. A single dose of IV parecoxib 40 mg was given 30 minutes before the end of surgery. Group ketorolac was given PCA morphine pre-mixed ketorolac with a concentration of 1.87 mg/mL. Daily and total morphine consumption, Visual Analog Score (VAS), and number of rescue attempts made up to 3 post-operative days, together with satisfaction score and incidence of side effects of PCA usage, were analyzed and compared by means of the Mann-Whitney U test; a value of P < .05 was regarded as significant, and data are given as mean ± SD.


RESULTS
Fifty patients were analyzed; group 1 comprised 21 patients and group 2 comprised 29 patients. There was no difference between group 1 and group 2 in terms of daily VAS. PCA morphine requirements were significantly lower at day 2 and day 3 in group 1. However, the total overall morphine usage and satisfactory score was not statistically different (P = .863, P = .052).


CONCLUSIONS
A single dose of IV parecoxib 40 mg can provide satisfactory pain control when paired with PCA morphine for donors undergoing living donor liver transplantation. The use of parecoxib in the multimodal analgesia regimen has similar efficacy, with possibly less morphine consumption, when compared with ketorolac.
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
K-I
KI
Lim
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-K
CK
Liu
Liver Transplantation Program and Surgery, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-L
CL
Chen
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-H
CH
Wang
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-J
CJ
Huang
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
K-W
KW
Cheng
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
S-C
SC
Wu
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
T-H
TH
Shih
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
S-C
SC
Yang
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Y-E
YE
Lee
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
B
B
Jawan
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: juangsinei@gmail.com.
S-E
SE
Juang
D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage; D020910:Ketorolac / Q000008:administration & dosage; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; D009020:Morphine; C409945:parecoxib; D020910:Ketorolac