The efficacy and safety of early initiation of preoperative analgesia with celecoxib in patients underwent arthroscopic knee surgery: A randomized, controlled study

Abstract

This study aimed to investigate the efficacy and safety of celecoxib 24 hours preoperative, 1 hour preoperative, and 4 hours postoperative administration in patients with arthroscopic knee surgery (AKS).In all, 206 patients who underwent AKS were consecutively recruited and randomized into 3 groups: (1) early preoperative analgesia group (EPEA), celecoxib 400 mg 24 hours preoperative administration; (2) preoperative analgesia group (PEA), celecoxib 400 mg 1 hour preoperative administration; (3) postoperative analgesia group (POA), celecoxib 400 mg 4 hours postoperative administration. Pain visual analog scale (VAS) scores (at rest and at 90 flexion) and patient global assessment (PGA) score were evaluated before and after operation, and also pethidine consumption and adverse events (AEs).The pain-rest VAS score, percentage of patients with moderate-severe pain at rest, and PGA score in the EPEA and PEA groups were decreased compared with POA group at 8 and 12 hours postoperation. Besides, pain-flexion to 90 VAS score in EPEA and PEA groups were also reduced compared with POA group at 8 hours postsurgery. Interestingly, the percentage of patients with moderate-severe pain at 90 flexion at 8 hours postsurgery in PEA group was fewer compared with POA group, whereas at 4 hours postoperation it was reduced in EPEA group compared with PEA and POA groups. As to consumption of pethidine, it was numerically decreased in EPEA and PEA groups compared with POA group. No difference between each 2 groups was found in AEs.Celecoxib was effective and safe as pre-emptive analgesia in AKS, and 1 hour administration before operation might be an optimal choice.

Figure 1

Study flow.

Figure 2

Comparison of the pain-rest VAS scores and the percentage of patients with moderate-severe pain at rest among EPEA group, PEA group, and POA group. (A) Comparison of the pain-rest VAS scores among EPEA group, PEA group, and POA group. (B) Comparison of the percentage of patients with moderate-severe pain at rest among EPEA group, PEA group, and POA group. Comparison between groups was performed by t test. P < .05 was considered significant. EPEA = early preoperative analgesia, PEA = preoperative analgesia, POA = postoperative analgesia, VAS = visual analog scale.

Figure 3

Comparison of the pain-flexion to 90^o VAS scores and the percentage of patients with moderate-severe pain at flexion to 90^o among EPEA group, PEA group, and POA group. (A) Comparison of the pain-flexion to 90^o VAS scores among EPEA group, PEA group, and POA group. (B) Comparison of the percentage of patients with moderate-severe pain at flexion to 90^o among EPEA group, PEA group, and POA group. Comparison between groups was performed by t test. P < .05 was considered significant. EPEA = early preoperative analgesia, PEA = preoperative analgesia, POA = postoperative analgesia, VAS = visual analogue scale.

Figure 4

Comparison of the PGA score among EPEA group, PEA group, and POA group. Comparison between groups was performed by t test. P < .05 was considered significant. EPEA = early preoperative analgesia, PEA = preoperative analgesia, PGA = patient global assessment, POA = postoperative analgesia.

Figure 5

Comparison of the consumption of pethidine among EPEA group, PEA group, and POA group. Comparison between groups was performed by t test. P < .05 was considered significant. EPEA = early preoperative analgesia, PEA = preoperative analgesia, POA = postoperative analgesia.

Figure 6

Comparison of the percentage of patients with AEs in EPEA group, PEA group, and POA group. Comparison between groups was performed by t test. P < .05 was considered significant. AEs = adverse events, EPEA = early preoperative analgesia group, PEA = preoperative analgesia group, POA = postoperative analgesia group.