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Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department

BACKGROUND: Parecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential a...

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Autores principales: Baharuddin, Kamarul Aryffin, Rahman, Nik Hisamuddin NA, Wahab, Shaik Farid Abdull, Halim, Nurkhairulnizam A, Ahmad, Rashidi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891999/
https://www.ncbi.nlm.nih.gov/pubmed/24386899
http://dx.doi.org/10.1186/1865-1380-7-2
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author Baharuddin, Kamarul Aryffin
Rahman, Nik Hisamuddin NA
Wahab, Shaik Farid Abdull
Halim, Nurkhairulnizam A
Ahmad, Rashidi
author_facet Baharuddin, Kamarul Aryffin
Rahman, Nik Hisamuddin NA
Wahab, Shaik Farid Abdull
Halim, Nurkhairulnizam A
Ahmad, Rashidi
author_sort Baharuddin, Kamarul Aryffin
collection PubMed
description BACKGROUND: Parecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential alternative analgesic agent in the ED by determining the mean reduction of pain score between acute traumatic pain patients who were administered with intravenous (IV) parecoxib sodium versus IV morphine sulfate. The onset of perceptible analgesic effect and side effects were also evaluated. METHODS: A randomized, double-blinded study comparing IV parecoxib 40 mg versus IV morphine at 0.10 mg/kg was conducted in adult patients presented with acute traumatic pain with numeric rating scale (NRS) of 6 or more within 6 hours of injury. Patients were randomized using a computer-generated randomization plan. Drug preparation and dispensing were performed by a pharmacist. Periodic assessment of blood pressure, pulse rate, oxygen saturation, and NRS were taken at 0, 5, 15, and 30 minute intervals after the administration of the study drug. The primary outcome was the reduction of NRS. Side effect and drug evaluation was conducted within 30 minutes of drug administration. RESULTS: There was no statistically significant difference in the reduction of mean NRS between patients in the IV parecoxib group or IV morphine group (P = 0.095). The mean NRS for patients treated with IV morphine were 7.1 at 0 minutes, 4.5 at 5 minutes, 3.1 at 15 minutes, and 2.0 at 30 minutes. Whereas mean NRS for patients who received IV parecoxib were 7.8 at 0 minutes, 5.7 at 5 minutes, 4.7 at 15 minutes, and 3.9 at 30 minutes. The onset of perceptible analgesic effects could be seen as early as 5 minutes. Dizziness was experienced in 42.9% of patients who received IV morphine compared to none in the parecoxib group. CONCLUSIONS: There was non-significant trend toward superiority of IV morphine over IV parecoxib. Looking at its effectiveness and the lack of opioid-related side-effects, the usage of IV parecoxib sodium may be extended further to a variety of cases in the ED.
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spelling pubmed-38919992014-01-24 Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department Baharuddin, Kamarul Aryffin Rahman, Nik Hisamuddin NA Wahab, Shaik Farid Abdull Halim, Nurkhairulnizam A Ahmad, Rashidi Int J Emerg Med Original Research BACKGROUND: Parecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential alternative analgesic agent in the ED by determining the mean reduction of pain score between acute traumatic pain patients who were administered with intravenous (IV) parecoxib sodium versus IV morphine sulfate. The onset of perceptible analgesic effect and side effects were also evaluated. METHODS: A randomized, double-blinded study comparing IV parecoxib 40 mg versus IV morphine at 0.10 mg/kg was conducted in adult patients presented with acute traumatic pain with numeric rating scale (NRS) of 6 or more within 6 hours of injury. Patients were randomized using a computer-generated randomization plan. Drug preparation and dispensing were performed by a pharmacist. Periodic assessment of blood pressure, pulse rate, oxygen saturation, and NRS were taken at 0, 5, 15, and 30 minute intervals after the administration of the study drug. The primary outcome was the reduction of NRS. Side effect and drug evaluation was conducted within 30 minutes of drug administration. RESULTS: There was no statistically significant difference in the reduction of mean NRS between patients in the IV parecoxib group or IV morphine group (P = 0.095). The mean NRS for patients treated with IV morphine were 7.1 at 0 minutes, 4.5 at 5 minutes, 3.1 at 15 minutes, and 2.0 at 30 minutes. Whereas mean NRS for patients who received IV parecoxib were 7.8 at 0 minutes, 5.7 at 5 minutes, 4.7 at 15 minutes, and 3.9 at 30 minutes. The onset of perceptible analgesic effects could be seen as early as 5 minutes. Dizziness was experienced in 42.9% of patients who received IV morphine compared to none in the parecoxib group. CONCLUSIONS: There was non-significant trend toward superiority of IV morphine over IV parecoxib. Looking at its effectiveness and the lack of opioid-related side-effects, the usage of IV parecoxib sodium may be extended further to a variety of cases in the ED. Springer 2014-01-03 /pmc/articles/PMC3891999/ /pubmed/24386899 http://dx.doi.org/10.1186/1865-1380-7-2 Text en Copyright © 2014 Baharuddin et al.; licensee Springer. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Baharuddin, Kamarul Aryffin
Rahman, Nik Hisamuddin NA
Wahab, Shaik Farid Abdull
Halim, Nurkhairulnizam A
Ahmad, Rashidi
Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
title Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
title_full Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
title_fullStr Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
title_full_unstemmed Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
title_short Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
title_sort intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891999/
https://www.ncbi.nlm.nih.gov/pubmed/24386899
http://dx.doi.org/10.1186/1865-1380-7-2
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