Effect of celecoxib combined with thoracic epidural analgesia on pain after thoracotomy
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M Senard1, E P Deflandre, D Ledoux
1Department of Anaesthesia and Intensive Care Medicine, Thoracic and Vascular Surgery, CHU de Liège, University of Liège, Domaine du Sart-Tilman, Liege, Belgium.
Background:
Thoracotomy results in severe postoperative pain potentially leading to chronic pain. We investigated the potential benefits of oral celecoxib on postoperative analgesia combined with thoracic epidural analgesia (TEA).
Methods:
Forty patients undergoing thoracotomy were included in this prospective, randomized, double-blind, placebo-controlled study. General anaesthesia was standardized. Patient-controlled epidural analgesia (T4-T5) was used during 48 h after surgery (ropivacaine 2 mg ml(-1) with sufentanil 0.5 microg ml(-1)). Patients were allocated to receive oral celecoxib or placebo from the evening before surgery until 48 h after operation. Postoperative pain scores, respiratory function, and morbidity were compared between the two groups.
Results:
Postoperative pain scores at rest (P=0.026) and during coughing (P=0.021) were lower and patient satisfaction was greater (P=0.0033) in the celecoxib group. Consumption of the local anaesthetic solution was comparable between groups. Postoperative restrictive pulmonary syndrome and morbidity were comparable between groups.
Conclusions:
Celecoxib improves postoperative analgesia provided by TEA after thoracotomy.
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