ESRA Academy. Noyes Essex M. Sep 8, 2016; 138482; 0340 Topic: MISCELLANEOUS
Disclosure(s): I , and my coauthors, are full-time employees and own stock in Pfizer Inc
Dr. Margaret Noyes Essex
Dr. Margaret Noyes Essex

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Background and Aims:

Pain is a major deterrent to postoperative mobilization and recovery. This analysis examined the effects of parecoxib on postoperative movement-related pain.


Data were from 3 trials of parecoxib that assessed postoperative pain following an aggravating movement and were approved by an appropriate ethics committee. Two trials compared single doses of placebo, morphine 4mg, ketorolac 30mg, parecoxib 20mg, or parecoxib 40mg administered the day following major gynecological surgery. Pain was assessed at 0.25, 0.50, 0.75, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, 10.0, 12.0, 16.0, and 24.0 hours after dosing. The third trial compared multiple doses of placebo, parecoxib 40mg (every 12 hours for 36 hours), propacetamol 2g (every 6 hours for 42 hours), or a combination of parecoxib 40mg/propacetamol 2g administered immediately following total hip replacement. Pain was assessed 24 hours post-surgery.


In the pooled gynecological studies, pain intensity was significantly lower for all treatments compared with placebo at 0.5–1.5 hours (all p<0.05) with the exception of parecoxib 20mg at 0.5 hours. The ketorolac and parecoxib groups, but not morphine, continued to exhibit significantly lower pain intensity scores relative to placebo at 2.0–24 hours (all p<0.05). In the hip study, pain intensity at 24 hours was significantly lower for parecoxib 40mg (p<0.05) and for the combination of parecoxib 40mg/propacetamol 2g (p<0.001) compared with placebo. The combination of parecoxib 40mg/propacetamol 2g resulted in significantly lower pain scores than propacetamol 2g alone (p<0.01).


 Parecoxib reduces post-surgical movement-related pain.

Sponsored by Pfizer Inc.

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