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Parecoxib versus tramadol for post-appendectomy pain.

Wacharin Sindhvananda¹, Pakorn Urusopone, Pin Sriprajittichai

¹Department of Anesthesiology, Chulalongkorn Hospital, Bangkok 10330, Thailand. wacharins@hotmail.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet

|February 14, 2006

Summary

For open appendectomy pain, parecoxib offers better pain control and less sedation compared to tramadol. This study found lower meperidine use and improved pain scores with parecoxib post-surgery.

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Area of Science:

Anesthesiology
Pharmacology
Surgical Pain Management

Background:

Open appendectomy typically involves low to moderate postoperative pain.
Multimodal pain therapy often incorporates non-opioid analgesics.
Parecoxib and tramadol are non-opioid options with potential benefits over traditional opioids.

Purpose of the Study:

To compare the efficacy of parecoxib versus tramadol in managing pain after open appendectomy.
To evaluate postoperative pain quality, sedation, nausea, vomiting, and patient satisfaction.

Main Methods:

A randomized study of 50 patients undergoing open appendectomy under spinal anesthesia.
Patients received either parecoxib (40 mg) or tramadol (50 mg) intravenously twice.
Pain, sedation, nausea/vomiting, and satisfaction scores were assessed at 6, 12, and 24 hours post-operation.

Main Results:

The parecoxib group required significantly less rescue meperidine (4.6 mg) compared to the tramadol group (18.6 mg) over 24 hours (p=0.005).
Patients receiving parecoxib reported lower pain scores at 24 hours (p=0.01) and lower sedation scores at 6 hours (p=0.003).

Conclusions:

Parecoxib demonstrates superior analgesia and reduced sedation compared to tramadol for post-appendectomy pain.
Parecoxib is a favorable choice as a primary analgesic in open appendectomy recovery.