Can intravenous parecoxib sodium decrease morphine consumption for acute postoperative pain following total knee arthroplasty?

Abstract

Objective: To assess the efficacy of intravenous parecoxib sodium in decreasing morphine consumption for acute postoperative pain following total knee arthroplasty. Design: Randomized double-blind controlled trial Setting: phramongkutklao hospital Method: Forty eight patients who were scheduled for total knee arthroplasty under spinal anesthesia Were randomly allocated into 2 groups by simple randomization. Group 1 received 40 mg. of parecoxib sodium and Group 2 received placebo (normal) saline) at Postanesthetic care unit and 12 hours later. Outcome variables included 24-hour morphine consumption, pain intensity score (measured by visual analog scale), nausea, pruritus and any adverse effect. Results: Only thirty-Six patients were enrolled in this study, The Mean + SD of 24-hour morphine Consumption in the study group is 20.57 + 9.44 mg. and 27.67 + 14.72 mg. in control group (p-value = 0.115.95% CI = -1.865-16.055). Measurement of pain intensity using visual analog scale pain Scores is 28.81 + 11.99 in the study group and 36.0 + 14.09 in control group. The result was not Statistically significant different (p-value=0..108). Incidences of nausea in both groups were 33.3% An incidence of vomiting in study group was 4.8 and 13.3% in control group. No any other side effect was detected. Conclusion: This study can not demonstrate that intravenous parecoxib sodium has significant effect in decreasing morphine consumption for acute posloperative pain following total knee arthroplasty, since the sample size is not adequate.