Purpose. In a randomized, double-blind trial, the efficacy of
nonopioid analgesics on postoperative
piritramide consumption was compared for
pain relief during the first 24 h in patients recovering from arthroscopic knee surgery. Methods. 120 patients were treated with
normal saline and/or one of the
nonopioid analgesics (
parecoxib,
metamizole,
paracetamol) in addition to
piritramide using the PCA pump. Beginning in the postanesthesia care unit (PACU), patients were asked to quantify their
pain experience at rest while
piritramide consumption was recorded. Results.
Piritramide consumption upon arrival in the PACU was high in all groups. However, cumulative consumption in the
parecoxib group was significantly lower than that in the placebo group at 6 and 12 h after surgery. At discharge from the PACU, VAS scores dropped in all groups and were significantly lower in the
parecoxib group. In the PACU, satisfaction of the patients was moderate and improved with time after surgery. Conclusions. There was statistically significant
opioid-saving effect by administering
parecoxib with better VAS scores and satisfaction level compared to placebo. The high
pain score in the PACU in all groups immediately after recovering from
remifentanil-based
anesthesia would be prevented if
local anesthetics were administered intra-articularly as part of a multimodal
analgesic approach.