Perioperative intravenous Parecoxib for pain management after laparoscopic colorectal cancer surgery

Objective To investigate the analgesic effect of perioperatively intravenous Parecoxib for pain management after laparoscopic surgery of colorectal cancer, and whether it can reduce opioid requirements and opioid-related adverse effects. Methods 116 patients ungergoing laparoscopic colorectal resection were randomized to receive either intravenous parecoxib at a dose of 40 mg 15 minutes before induction of anesthesia followed by 40 mg every 12 hous for 72 hours (Parecoxib Group, n=59) or without the use of Parecoxib (control group, n=57). All patients had access to patient controlled analgesia (PCA) with Sufentanil within 48 hours after the operation. Patients were assessed with respect to Visual Analog Scale (VAS) from 0-10, and supplementary opiates were provided when VAS was above 4. Results Compared with control group, Parecoxib group had lower VAS scores at rest, while coughing and mobilization at each time point after the operation (P 0.05). The postoperative hospital stay was less in Parecoxib group (P<0.05), and Parecoxib group consumed less opium on post-op day 1 [0 mg(0, 7.5)vs.10 mg(7.5, 15), Z=2 364, P=0.000], and less total opium consumption in 5 days after surgery [20 mg (10, 25) vs. 42.5 mg (37.5, 45), Z=1 770, P=0.000]. Conclusions The use of Parecoxib with PCA Sufentanil in postoperative analgesia resulted in comprehensive enhancement of the analgesic efficacy, reducing the opioid requirement, promoting postoperative recovery and shortening hospital stay. Key words: Colorectal neoplasms; Pain management; Perioperative period; Parecoxib