Single bolus parecoxib attenuates sore throat after laryngeal microsurgery: a randomized double-blind control study

Laryngeal microsurgery is performed to assess disorders of the larynx. Parecoxib is the only parenterally administered selective cyclooxygenase (COX)-2 inhibitor widely used in acute pain control. The purpose of this study is to assess the analgesic effects of parecoxib compared with morphine for postoperative sore throat in patients undergoing laryngeal microsurgery. Fifty patients were randomly allocated to receive either parecoxib 0.5 mg/kg or morphine 50 microg/kg prior to anesthesia induction. General anesthesia was maintained with sevoflurane 2-4%. Postoperative sore throat and other outcomes were measured at a postanesthesia care unit (PACU) 4 hours and 24 hours postoperatively. The severity of postoperative sore throat was assessed by sore throat score as follows: none (0) = no pharyngeal or laryngeal discomfort; mild (1) = no pain at rest, but swallowing induced mild pain or discomfort; moderate (2) = constant pain without swallowing exacerbation; and severe (3) = constant pain with swallowing or respiratory exacerbation. The incidences of postoperative side effects (nausea, vomiting, itching, dizziness, and somnolence) were also recorded. Demographic data from the parecoxib (n = 25) and morphine (n = 25) groups did not differ significantly. The parecoxib group depicted similar sore throat scores as the morphine group at three measured postoperative time points. Patients requiring postoperative analgesics were comparable between the parecoxib group and morphine group (2/25, 8% vs. 3/25, 12%, p = 0.64). Overall postoperative adverse events were fewer in the parecoxib group than the morphine group (3/25, 12% vs. 9/25, 36%, p = 0.047). Both parecoxib and morphine are effective to attenuate postoperative sore throat after laryngeal microsurgery. Parecoxib may be an effective and well-tolerated injectable analgesic to manage postoperative sore throat after laryngeal microsurgery.