title: Parecoxib Provides Analgesic and Opioid-Sparing Effects Following Major Orthopedic Surgery: A Subset Analysis of a Randomized, Placebo-Controlled Clinical Trial.
abstract: BACKGROUND
  Orthopedic surgeries are among the most common and most painful surgeries performed. A multimodal analgesic approach is recommended to reduce opioid consumption, provide effective pain relief, and improve outcomes following surgery. This study examined the efficacy and opioid-sparing effects of parecoxib following major orthopedic surgery.
  
  
  METHODS
  This subset analysis of a large, multicenter, randomized, double-blind, placebo-controlled study of parecoxib examined treatment effects on postoperative pain severity, pain interference with function, opioid consumption, occurrence of opioid-related symptoms, safety, and patient satisfaction following major orthopedic surgery.
  
  
  RESULTS
  Pain scores were significantly lower in the parecoxib group (n = 142) compared with placebo (n = 139) on day 2 (-22%; p < 0.001) and day 3 (-17%; p = 0.004). Pain interference with function scores were also significantly lower in the parecoxib group on day 2 (-32%; p < 0.001) and day 3 (-27%; p = 0.003) relative to placebo. Additionally, significantly less supplemental morphine was required in the parecoxib group relative to placebo through 24 h (-28%; p = 0.008) and 48 h (-33%; p < 0.001). Patients in the parecoxib group had a reduced risk of experiencing opioid-related symptoms including fatigue, drowsiness, inability to concentrate, confusion, nausea, constipation, and confusion on day 2 and/or day 3. Finally, more patients receiving parecoxib (42%) rated treatment as "excellent" compared to those receiving placebo (21%).
  
  
  CONCLUSIONS
  These findings support the use of parecoxib for the management of pain following major orthopedic surgery.
authors.affiliation: Orthopedics and Traumatology, Hospital Angeles Lomas, Huixquilucan, Mexico.
authors.forename: Efrain
authors.initials: E
authors.lastname: Diaz-Borjon
authors.affiliation: Orthopaedics, ABC Medical Center, Mexico City, Mexico.
authors.forename: Armando
authors.initials: A
authors.lastname: Torres-Gomez
authors.affiliation: Global Medical Affairs, Pfizer Inc, New York, NY, USA. Margaret.essex@pfizer.com.
authors.forename: Margaret Noyes
authors.initials: MN
authors.lastname: Essex
authors.affiliation: Pain Division for Latin America, Pfizer Inc, Mexico City, Mexico.
authors.forename: Patricia
authors.initials: P
authors.lastname: Salomon
authors.affiliation: Statistics, Pfizer Inc, Madison, NJ, USA.
authors.forename: Chunming
authors.initials: C
authors.lastname: Li
authors.affiliation: Global Medical Affairs, Pfizer Inc, New York, NY, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Cheung
authors.affiliation: Global Medical Affairs, Pfizer Inc, New York, NY, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Parsons
keywords: Opioid-sparing; Orthopedic surgery; Parecoxib; Postoperative pain