Is celecoxib a useful adjunct in the treatment of post-tonsillectomy pain in the adult population? A randomised, double-blind, placebo-controlled study.
OBJECTIVE
To evaluate the efficacy and safety of celecoxib for pain management in post-tonsillectomy adult patients.


METHODS
A randomised, double-blind, placebo-controlled, phase 3 clinical trial was conducted in an adult population (aged 18-55 years), with a parallel group design using an allocation ratio of 1:1.


METHODS
Eighty patients underwent elective tonsillectomy or adenotonsillectomy, operated on by one surgeon. They were discharged home with randomly assigned celecoxib or placebo, together with regular post-tonsillectomy medications (paracetamol and Endone). Pain scores were measured from post-operative days 1 to 10. All patients were assessed on post-operative days 5, 12 and 28.


RESULTS
There were no statistically significant differences in the daily or overall pain scores, the total intake of Endone, or the time taken to achieve freedom from pain after tonsillectomy between the study arms (n = 40 each arm). The celecoxib-treated group experienced significantly more vomiting (celecoxib vs placebo p < 0.001 (Mann-Whitney test), confidence interval = 0.57 to 0.76).


CONCLUSIONS
Celecoxib usage was associated with significantly more vomiting and did not reduce narcotic analgesia requirement post-tonsillectomy.
ENT Unit,Department of Surgery,Frankston Hospital,Peninsula Health,Frankston,Australia.
T-T
TT
Ng
ENT Unit,Department of Surgery,Frankston Hospital,Peninsula Health,Frankston,Australia.
D
D
Diamantaras
ENT Unit,Department of Surgery,Frankston Hospital,Peninsula Health,Frankston,Australia.
J
J
Priestley
ENT Unit,Department of Surgery,Frankston Hospital,Peninsula Health,Frankston,Australia.
J
J
Redman
ENT Unit,Department of Surgery,Frankston Hospital,Peninsula Health,Frankston,Australia.
N
N
De Silva
ENT Unit,Department of Surgery,Frankston Hospital,Peninsula Health,Frankston,Australia.
V
V
Mahanta
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000068579:Celecoxib / Q000627:therapeutic use*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010098:Oxycodone / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D014068:Tonsillectomy; D055815:Young Adult
D000700:Analgesics; D052246:Cyclooxygenase 2 Inhibitors; D000082:Acetaminophen; D010098:Oxycodone; D000068579:Celecoxib
Analgesia; Celecoxib; Cyclooxygenase 2 Inhibitors; Double-Blind Method; Hemorrhage; Postoperative Complications; Prospective Studies; Tonsillectomy