Abstract | OBJECTIVE: This study was designed to assess the efficacy of perioperative administration of celecoxib ( Celebrex; Pharmacia GmbH, Erlangen, Germany) in reducing pain and opioid requirements after single-level lumbar microdiscectomy. METHODS: We studied 34 patients (mean age, 44.26 yr; standard deviation [SD], 13.09 yr) allocated randomly to receive celecoxib 200 mg twice a day for 72 hours starting on the evening before surgery or placebo capsules in a double-blind study. Fourteen patients received 20 to 80 mg dexamethasone intravenously during surgery (mean, 40 mg; SD, 19.22 mg) because of visible signs of compression of the affected nerve root. After lumbar disc surgery, patients were monitored for visual analog scores for pain at rest and on movement, patient-controlled analgesia (PCA) piritramide requirements, and von Frey thresholds in the wound area. RESULTS:
Pain scores decreased and wound von Frey thresholds increased continuously until discharge, with no intergroup differences. Mean 24-hour PCA piritramide requirements were 22.63 mg (SD, 23.72 mg) and 26.14 mg (SD, 22.57 mg) in the celecoxib and placebo groups, respectively (P = not significant). However, patients with intraoperative dexamethasone (n = 14) required only 10.29 mg (SD, 8.55 mg) 24-hour PCA piritramide, in contrast to the 34.25 mg (SD, 24.69 mg) needed in those who did not receive intraoperative dexamethasone (P = 0.001). In addition, 24 hours after the operation, pain scores on movement were significantly lower in the dexamethasone subgroup (P = 0.003). CONCLUSION:
|
Authors | Matthias Karst, Tanja Kegel, Anne Lukas, Wolf Lüdemann, Samii Hussein, Siegfried Piepenbrock |
Journal | Neurosurgery
(Neurosurgery)
Vol. 53
Issue 2
Pg. 331-6; discussion 336-7
(Aug 2003)
ISSN: 0148-396X [Print] United States |
PMID | 12925248
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Analgesics, Opioid
- Anti-Inflammatory Agents, Non-Steroidal
- Pyrazoles
- Sulfonamides
- Pirinitramide
- Dexamethasone
- Celecoxib
|
Topics |
- Adult
- Analgesia, Patient-Controlled
- Analgesics, Opioid
(administration & dosage, therapeutic use)
- Anti-Inflammatory Agents, Non-Steroidal
(administration & dosage, therapeutic use)
- Celecoxib
- Dexamethasone
(administration & dosage, therapeutic use)
- Diskectomy
(adverse effects)
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Humans
- Intervertebral Disc Displacement
(surgery)
- Lumbar Vertebrae
(surgery)
- Male
- Microsurgery
(adverse effects)
- Middle Aged
- Pain Measurement
- Pain, Postoperative
(drug therapy, etiology)
- Perioperative Care
- Pirinitramide
(administration & dosage, therapeutic use)
- Pyrazoles
- Sulfonamides
(administration & dosage, therapeutic use)
|