Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation
Adequacy of postoperative pain control is one of the most important factors in determining when a patient can be safely discharged from a surgical facility. Furthermore, it has a major influence on the patient’s ability to resume the normal activities of daily living. Tramadol is a weak opioid analg...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English English |
| Published: |
Confederation of ASEAN Societies of Anaesthesiologists
2007
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/11297/ http://irep.iium.edu.my/11297/1/AsJournVol8May07.pdf http://irep.iium.edu.my/11297/4/AsJournVol8May07_content.pdf |
| Summary: | Adequacy of postoperative pain control is one of the most important factors in determining when a patient can be safely discharged from a surgical facility. Furthermore, it has a major influence on the patient’s ability to resume the normal activities of daily living. Tramadol is a weak opioid analgesic that acts mainly on μ-opioid receptor and has been proven to provide effective and safe analgesic to post-operative patients.
Celecoxib (celebrex) is a highly selective COX-2 inhibitor. It belongs to nonsteroidal anti-inflammatory drugs
(NSAIDs) group which reduces inflammation and pain while minimizing gastrointestinal adverse reaction.
This selectivity feature makes celecoxib an attractive alternative to opioids for the control of postoperative
pain.
The purpose of this study was to evaluate the effectiveness of oral celecoxib, in comparison with oral
tramadol, in term of analgesic properties and the need for additional tablet acetaminophen as rescue pain
reliever in patients undergoing elective gynecological operation.
A randomized, single-blinded study was conducted on 100 ASA I and II patients who were randomized
into two groups: tramadol or celecoxib. Following major gynaecological surgery, all patients were given
standard patient-controlled analgesia (PCA) regime with intravenous morphine. Patients either received oral
tramadol 100 mg 8 hourly or oral celecoxib 200mg 12 hourly for analgesia 24 hours post operation. Tablet
acetaminophen was available as a rescue analgesic. Patients were monitored for pain according to Modified
Pain Score, haemodynamic changes and side effects. They were evaluated at 24, 32, 40 and 48 hours post
operation. The mean pain score at 24, 32, 40 and 48 hours post operation were 0.86 ± 0.45, 0.68 ± 0.47,
0.42 ± 0.50, and 0.14 ± 0.35 in celecoxib group and 0.92 ± 0.44, 0.78 ± 0.41, 0.46 ± 0.54 and 0.18 ± 0.39 in
tramadol group respectively. There were no significant differences in the mean pain score and between the
two groups at each point of assessment (p>0.05). None of the patients requested for tablet acetaminophen.
Patient satisfaction was similar in both study groups.
This study indicates that oral celecoxib 200 mg 12 hourly is adequate and suitable to be used as an
alternative to oral tramadol 100 mg 8 hourly in controlling pain 24 hours following major operation without
the need for additional tablet acetaminophen.
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