Perioperative
parecoxib administration reduces
postoperative pain,
opioid consumption, and adverse events in adult patients. However, the efficacy and safety of
parecoxib in children remain unclear. This metaanalysis included related published studies to address this concern. Eight databases in the literature until February 2015 were systematically explored to identify randomized controlled trials (RCTs) comparing perioperative
parecoxib administration and placebo/standard treatments for
acute postoperative pain in children. Primary outcomes were
postoperative pain scores and adverse events. The Face, Legs, Activity, Crying, Consolability scale was used to score
pain in children younger than 6 years, whereas the Visual Analog Scale was used in children older than 6 years. Secondary outcomes were sedation scores (measured using the Ramsay scale), agitation scores (measured using the Sedation-Agitation Scale), and
opioid consumption. The methodological quality of RCTs was independently assessed in accordance with the "Risk of bias" of Cochrane Collaboration. Data were analyzed using Review Manager 5.2. Twelve RCTs involving 994 patients met the inclusion criteria. Compared with children who received placebo treatment, those who received
parecoxib demonstrated lower early (2 h) and later (12 h)
postoperative pain scores; lower incidence rates of
postoperative nausea,
vomiting, and agitation; higher early (1 h) postoperative sedation scores; and lower agitation scores. Similarly, children who received
parecoxib had lower early (2 h) and later (12 h)
postoperative pain scores, lower incidence rates of
postoperative nausea and vomiting, and lower early (1 h) postoperative sedation scores compared with those who received standard treatments; however, these children showed no significant difference in agitation scores. Unfortunately, data on the effect of
parecoxib on
opioid consumption were insufficient. Overall, these results suggested that perioperative
parecoxib administration was associated with less
acute postoperative pain and fewer adverse events compared with placebo or standard treatments.
Parecoxib administration also resulted in less
emergence agitation compared with placebo treatment and less excessive sedation concern compared with standard treatments. However, the long-term effects, effects on
opioid consumption, and patient satisfaction of
parecoxib administration warrant further investigation.