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. 2016 Nov 25:9:1101-1107.
doi: 10.2147/JPR.S111733. eCollection 2016.

Effects of parecoxib on postoperative pain and opioid-related symptoms following gynecologic surgery

Bruce Parsons  1 , Qijiang Zhu  2 , Li Xie  3 , Chunming Li  1 , Raymond Cheung  1
Affiliations

Effects of parecoxib on postoperative pain and opioid-related symptoms following gynecologic surgery

Bruce Parsons et al. J Pain Res. .

Abstract

Objective: To examine the analgesic and opioid-sparing effects of parecoxib following major gynecologic surgery.

Methods: This is a large subset analysis of patients from a multicenter, randomized, double-blind, placebo-controlled study of parecoxib/valdecoxib (PAR/VAL) for postoperative pain. Pain severity, pain interference with function, opioid use, occurrence of opioid-related symptoms, and Patient/Physician Global Evaluation of Study Medication were compared between placebo and PAR/VAL treatment groups in the days following surgery.

Results: Pain scores were reduced in the PAR/VAL group (n=98), relative to placebo (n=97), on Day 2 (-21%, P<0.001) and Day 3 (-23%, P=0.004). Pain interference with function scores were also significantly lower in the PAR/VAL group, compared with placebo, on Day 2 (-29%, P<0.001) and Day 3 (-28%, P=0.013). Consumption of supplemental morphine was significantly lower in the PAR/VAL group relative to placebo at 24 hours (-37%, P=0.010) and trended lower at 48 (-28%) and 72 hours (-26%). Patients in the PAR/VAL group also had a reduced risk of experiencing specific opioid-related symptoms, including "inability to concentrate" (relative risk =0.53) and "nausea" (relative risk =0.60) on Day 2. Both Patient and Physician Global Evaluation of Study Medication scores were better in the PAR/VAL group than in the placebo group.

Conclusion: The current study adds support for the use of parecoxib in patients following major gynecologic surgery.

Keywords: gynecologic surgery; parecoxib; postoperative pain.

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Conflict of interest statement

The original clinical trial and this subset analysis were sponsored by Pfizer Inc. Bruce Parsons, Li Xie, Chunming Li, and Raymond Cheung are full-time employees of Pfizer and own stock in Pfizer. The authors report no other conflicts of interests in this work.

Figures

Figure 1
Figure 1
Mean SPI-24 scores on Days 2 and 3 following surgery. Notes: *P<0.001 versus placebo; **P<0.010 versus placebo. Abbreviations: PAR/VAL, parecoxib/valdecoxib; SPI-24, summed pain intensity over 24 hours; SD, standard deviation.
Figure 2
Figure 2
Mean mBPI-sf composite pain interference with function scores on Days 2 and 3 following surgery. Notes: *P<0.001 versus placebo; **P<0.05 versus placebo. Abbreviations: mBPI-sf, modified brief pain inventory – short form; PAR/VAL, parecoxib/valdecoxib; SD, standard deviation.
Figure 3
Figure 3
Cumulative supplemental morphine consumption at 24, 48, and 72 hours after initial dose following surgery. Note: *P=0.010 versus placebo. Abbreviations: PAR/VAL, parecoxib/valdecoxib; SD, standard deviation.
Figure 4
Figure 4
Patient (A) and Physician (B) Global Evaluation of Study Medication scores at the time of transition from IV/IM to oral dosing. Abbreviations: IM, intramuscular; IV, intravenous; PAR/VAL, parecoxib/valdecoxib.
See this image and copyright information in PMC

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