The authors declare that they have no competing interests.
KS: Main researcher who designed and performed study, and prepared the manuscript; JC: assisted in the research process and statistical analysis; BS: advised concerning study design and methods and offered critical commentary on the manuscript; SN: assisted in the research process and revision of the manuscript. All authors read and approved the final manuscript.
KS is an orthopaedic surgeon at the Department of Orthopaedics, Faculty of Medicine, Prince of Songkla University, experienced in spine surgery.
JC is an orthopaedic surgeon at the Department of Orthopaedics, Faculty of Medicine, Prince of Songkla University and assisted in the study research.
BS is an orthopaedic surgeon, and an expert in epidemiology, working in the Department of Orthopaedics, Faculty of Medicine, Prince of Songkla University.
SN is an anesthesiologist and expert in pain management, working in the Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University.
Poor postoperative pain control is frequently associated with complications and delayed discharge from a hospital. Preemptive analgesia is one of the methods suggested for reducing postoperative pain. Opioids are effective for pain control, but there known addictive properties make physicians cautious about using them. Parecoxib and ketorolac are potent non-opioid NSAIDs that are attractive alternative drugs to opioids to avoid opioid-related side effects. However, there are no good head-to-head comparisons between these two drugs in the aspect of preemptive analgesic effects in lumbar spinal fusion surgery. This study aimed to compare the efficacy in terms of postoperative pain control and safety of parecoxib with ketorolac as preemptive analgesia in posterior lumbar spinal fusion patients.
A prospective, double-blinded randomized controlled trial was carried out in patients undergoing posterior lumbar spinal fusion, who were randomized into 3 groups (n = 32). Parecoxib, ketorolac or a placebo was given to each patient via injection around 30 minutes prior to incision. The efficacy of postoperative pain control was assessed by a verbal numerical rating score (0–10). And various postoperative things were monitored for analysis, such as total opioid consumption, complications, and estimated blood loss.
Both the ketorolac and parecoxib groups showed significantly better early postoperative pain reduction at the postanesthesia care unit (PACU) than the control group (p < 0.05). There were no differences between the pain scores of ketorolac and parecoxib at any time points. Complications and bleeding were not significantly different between all three groups.
Preemptive analgesia using both ketorolac and parecoxib showed a significantly better early postoperative pain control in the PACU than the control group in patients undergoing lumbar spinal fusion.
ClinicalTrials.gov NCT01859585. Registered 15 May 2013.
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- Comparing parecoxib and ketorolac as preemptive analgesia in patients undergoing posterior lumbar spinal fusion: a prospective randomized double-blinded placebo-controlled trial
- BioMed Central
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