Timing of intraoperative parecoxib analgesia in colorectal surgery

Objective

The aim of this study was to determine the analgesic effect of parecoxib when administered either before or at the end of surgery in patients undergoing colorectal laparotomy.

Methods

Sixty patients were randomised to three groups of 20. The PS group received intravenous parecoxib 40 mg before skin incision and normal saline at skin closure. The SP group received saline before skin incision and intravenous parecoxib 40 mg at skin closure. A control group (SS) received saline at both time points.

Results

In both SP and PS groups, morphine consumption was smaller. There was a 40–55% reduction in cumulative morphine consumption in both treatment groups at all time points up to 48 h after anaesthesia finished. The greatest reduction was from 12 h to 24 h which showed a 66% reduction for the SP group and a 55% reduction for the PS group compared to control (p = 0.0003 and 0.0049, respectively, with an adjusted significance value = 0.0167). For SP and PS groups, the time to first post-operative analgesic request tended to be longer and the number of patients requesting morphine in the recovery room was less.

Conclusion

Parecoxib administration at the end of surgery is as effective as at the beginning with regard to analgesic and opioid-sparing effects.