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Parecoxib in laparoscopic surgery for simple vesicular lithiasis.

Faten Haddad, Hazem Jaoua, Ali Mrabet

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    Parecoxib significantly reduced postoperative pain and opioid use in patients undergoing laparoscopic cholecystectomy. This analgesic also decreased the incidence of chronic pain one year after surgery.

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    Area of Science:

    • Anesthesiology
    • Surgical Pain Management
    • Pharmacology

    Background:

    • Multimodal analgesia is crucial for managing pain after laparoscopic cholecystectomy.
    • Non-steroidal anti-inflammatory drugs (NSAIDs) are often incorporated into multimodal pain protocols.
    • Parecoxib, a selective COX-2 inhibitor, has shown promise in postoperative pain management.

    Purpose of the Study:

    • To assess the efficacy of parecoxib as part of a multimodal analgesia protocol for laparoscopic cholecystectomy.
    • To evaluate parecoxib's impact on acute postoperative pain, opioid consumption, and chronic pain development.

    Main Methods:

    • A prospective, randomized, double-blind study involving 60 patients undergoing laparoscopic cholecystectomy.
    • Patients received either parecoxib 40 mg or a placebo 30 minutes before induction.
    • Pain scores, analgesic requirements, and chronic pain incidence were assessed during hospitalization and at one-year follow-up.

    Main Results:

    • Parecoxib significantly reduced pain scores at rest and during coughing on postoperative day one.
    • Opioid requirements (morphine and tramadol) were significantly lower in the parecoxib group.
    • The incidence of chronic pain one year post-surgery was significantly lower in the parecoxib group (8% vs. 37.5%).

    Conclusions:

    • Parecoxib (40 mg) administered preoperatively is effective in managing acute pain after laparoscopic cholecystectomy.
    • Preoperative parecoxib contributes to opioid-sparing effects.
    • The use of parecoxib is associated with a significant reduction in the development of chronic pain following the procedure.