Perioperative celebrex administration for pain management after total knee arthroplasty a a randomized, controlled study
Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal management of postoperative pain. We evaluated opioid-sparing effects and rehabilitation results after administration of perioperative celecoxib for total knee arthroplasty.
Methods: This was a prospective, randomized, observer-blind control study.
Eighty patients that underwent total knee arthroplasty were randomized into two groups. The study group (n=40) received a single 400mg dose of celecoxib one hour before surgery, and 200mg celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA) morphine.
The control group (n=40) received only PCA morphine for postoperative pain management. Visual analog scale (VAS) pain scores, active movement, total analgesic use and postoperative nausea/vomiting were analyzed.
Results: Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. VAS pain scores significantly improved in the study group, at rest (p=0.002) or during activity (p=0.05).
Active ROM also increased significantly in patients receiving celecoxib, especially in the first 72 hrs (p<0.001). Analgesic dosage decreased about 40% (p=0.03) in this group, while post-operative nausea/vomiting decreased about 15%.
Celecoxib resulted in no significant increase in postoperative blood loss or the need for blood transfusion.
Conclusions: Perioperative celecoxib significantly improved pain scores, opioid consumption, and rehabilitation outcomes after total knee arthroplasty, without increasing the risk of bleeding.Trial registrationClinicaltrials.gov NCT00598234
Author: Yu-Min Huang, Chiu-Meng Wang, Chen-Ti Wang, Wei-Peng Lin, Lih-Ching Horng and Ching-Chuan Jiang
Credits/Source: BMC Musculoskeletal Disorders 2008, 9:77
Published on: 2008-06-03
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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