Effects of parecoxib on postoperative pain and opioid-related symptoms following gynecologic surgery

OBJECTIVE: To examine the analgesic and opioid-sparing effects of parecoxib following major gynecologic surgery. METHODS: This is a large subset analysis of patients from a multicenter, randomized, double-blind, placebo-controlled study of parecoxib/valdecoxib (PAR/VAL) for postoperative pain. Pain severity, pain interference with function, opioid use, occurrence of opioid-related symptoms, and Patient/Physician Global Evaluation of Study Medication were compared between placebo and PAR/VAL treatment groups in the days following surgery. RESULTS: Pain scores were reduced in the PAR/VAL group (n=98), relative to placebo (n=97), on Day 2 (−21%, P<0.001) and Day 3 (−23%, P=0.004). Pain interference with function scores were also significantly lower in the PAR/VAL group, compared with placebo, on Day 2 (−29%, P<0.001) and Day 3 (−28%, P=0.013). Consumption of supplemental morphine was significantly lower in the PAR/VAL group relative to placebo at 24 hours (−37%, P=0.010) and trended lower at 48 (−28%) and 72 hours (−26%). Patients in the PAR/VAL group also had a reduced risk of experiencing specific opioid-related symptoms, including “inability to concentrate” (relative risk =0.53) and “nausea” (relative risk =0.60) on Day 2. Both Patient and Physician Global Evaluation of Study Medication scores were better in the PAR/VAL group than in the placebo group. CONCLUSION: The current study adds support for the use of parecoxib in patients following major gynecologic surgery.