Effects of preoperative single dose Etoricoxib on postoperative pain and sleep after lumbar diskectomy: prospective...

Etoricoxib, a selective Cox-2 inhibitor has been found to be effective in the management of acute pain. This study evaluates the effect of preoperative use of oral Etoricoxib on post operative pain relief and sleep in patients undergoing single level diskectomy.

In this prospective, randomized, controlled study, forty four patient (ASA 1 & 2, age 18-60 years) scheduled to undergo single level lumber diskectomy were given either placebo (control group) or Etoricoxib 120 mg orally one hour before surgery. Post operatively fentanyl intravenous (IV) PCA pump was started. Visual analog score (VAS) was assessed at 0, 6, 12, 18 and 24 hours at rest and movement. Primary end point was total pain relief over 24 hours. Sleep overnight, total fentanyl consumption, incidence of nausea and vomiting, intra-operative blood loss and patient satisfaction were noted.

Forty three patients completed the study. Reductions in VAS at rest and on movement were observed in the Etoricoxib group when compared with the Control group at all the intervals till 24 hours postoperatively, except on movement at 24 hours postoperative (P < 0.05). Total fentanyl consumption (microg/kg/hr) was higher in Control group (P = 0.007). More patients in Etoricoxib group had a contented facial expression (p = 0.003), relaxed body language (p = 0.00) and better sleep at night than control group (p = 0.0004).

Single preoperative oral dose (120 mg) of Etoricoxib, given one hour before surgery, has significantly reduced the post operative pain at rest and movement and improved sleep in patients undergoing single level diskectomy without any side effects and with good patient satisfaction.