Cargando…

Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction

BACKGROUND: A nonsteroidal anti-inflammatory drug such as oral diclofenac is normally used to relieve postoperative pain after anterior cruciate ligament reconstruction (ACLR), but most patients continue to have moderate-to-severe pain that disturbs their rehabilitation. Some orthopaedists prefer to...

Descripción completa

Detalles Bibliográficos
Autores principales: Chuaychoosakoon, Chaiwat, Parinyakhup, Wachiraphan, Wiwatboworn, Arnan, Purngpiputtrakul, Peeranut, Wanasitchaiwat, Pawin, Boonriong, Tanarat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532231/
https://www.ncbi.nlm.nih.gov/pubmed/34692879
http://dx.doi.org/10.1177/23259671211041660
_version_ 1784587025863671808
author Chuaychoosakoon, Chaiwat
Parinyakhup, Wachiraphan
Wiwatboworn, Arnan
Purngpiputtrakul, Peeranut
Wanasitchaiwat, Pawin
Boonriong, Tanarat
author_facet Chuaychoosakoon, Chaiwat
Parinyakhup, Wachiraphan
Wiwatboworn, Arnan
Purngpiputtrakul, Peeranut
Wanasitchaiwat, Pawin
Boonriong, Tanarat
author_sort Chuaychoosakoon, Chaiwat
collection PubMed
description BACKGROUND: A nonsteroidal anti-inflammatory drug such as oral diclofenac is normally used to relieve postoperative pain after anterior cruciate ligament reconstruction (ACLR), but most patients continue to have moderate-to-severe pain that disturbs their rehabilitation. Some orthopaedists prefer to use intravenous (IV) parecoxib for postoperative pain control. PURPOSE: To compare the efficacy of IV parecoxib and oral diclofenac for postoperative pain control in ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively collected and analyzed postoperative pain in patients who underwent both single- and double-bundle ACLR; pain was reported on a 10-point visual analog scale (VAS; 10 = worst pain). After the operation, each patient was given either IV parecoxib twice a day or oral diclofenac 3 times a day, and all patients received paracetamol 6 times per day for 24 hours postoperatively. If the patient complained of moderate or severe pain (VAS >3) after surgery, 3 mg of morphine would be given intravenously every 3 hours and 1 mg of morphine as a rescue analgesic every 1 hour for 24 hours postoperatively. Postoperative VAS and morphine consumption were recorded every 4 hours for 24 hours. Data were analyzed using paired t test, analysis of variance, and chi-square test. RESULTS: Overall, 161 patients were included in this study, of whom 47 received IV parecoxib and 114 received oral diclofenac. The mean VAS scores at 4 and 8 hours postoperatively were 3.5 and 3.4, respectively, in the parecoxib group, and 4.4 and 4.7, respectively, in the diclofenac group. The parecoxib group had significantly lower mean VAS than the diclofenac group at 4 hours (P = .047) and 8 hours (P = .005), and the mean cumulative morphine consumption in the parecoxib group was significantly lower than in the diclofenac group at all time points (P < .05) except 4 hours postoperatively. CONCLUSION: This study found that IV parecoxib was more effective than oral diclofenac in controlling postoperative pain and resulted in lower postoperative morphine consumption within the first 24 hours after ACLR.
format Online
Article
Text
id pubmed-8532231
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-85322312021-10-23 Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction Chuaychoosakoon, Chaiwat Parinyakhup, Wachiraphan Wiwatboworn, Arnan Purngpiputtrakul, Peeranut Wanasitchaiwat, Pawin Boonriong, Tanarat Orthop J Sports Med Article BACKGROUND: A nonsteroidal anti-inflammatory drug such as oral diclofenac is normally used to relieve postoperative pain after anterior cruciate ligament reconstruction (ACLR), but most patients continue to have moderate-to-severe pain that disturbs their rehabilitation. Some orthopaedists prefer to use intravenous (IV) parecoxib for postoperative pain control. PURPOSE: To compare the efficacy of IV parecoxib and oral diclofenac for postoperative pain control in ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively collected and analyzed postoperative pain in patients who underwent both single- and double-bundle ACLR; pain was reported on a 10-point visual analog scale (VAS; 10 = worst pain). After the operation, each patient was given either IV parecoxib twice a day or oral diclofenac 3 times a day, and all patients received paracetamol 6 times per day for 24 hours postoperatively. If the patient complained of moderate or severe pain (VAS >3) after surgery, 3 mg of morphine would be given intravenously every 3 hours and 1 mg of morphine as a rescue analgesic every 1 hour for 24 hours postoperatively. Postoperative VAS and morphine consumption were recorded every 4 hours for 24 hours. Data were analyzed using paired t test, analysis of variance, and chi-square test. RESULTS: Overall, 161 patients were included in this study, of whom 47 received IV parecoxib and 114 received oral diclofenac. The mean VAS scores at 4 and 8 hours postoperatively were 3.5 and 3.4, respectively, in the parecoxib group, and 4.4 and 4.7, respectively, in the diclofenac group. The parecoxib group had significantly lower mean VAS than the diclofenac group at 4 hours (P = .047) and 8 hours (P = .005), and the mean cumulative morphine consumption in the parecoxib group was significantly lower than in the diclofenac group at all time points (P < .05) except 4 hours postoperatively. CONCLUSION: This study found that IV parecoxib was more effective than oral diclofenac in controlling postoperative pain and resulted in lower postoperative morphine consumption within the first 24 hours after ACLR. SAGE Publications 2021-10-20 /pmc/articles/PMC8532231/ /pubmed/34692879 http://dx.doi.org/10.1177/23259671211041660 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Chuaychoosakoon, Chaiwat
Parinyakhup, Wachiraphan
Wiwatboworn, Arnan
Purngpiputtrakul, Peeranut
Wanasitchaiwat, Pawin
Boonriong, Tanarat
Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction
title Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction
title_full Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction
title_fullStr Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction
title_full_unstemmed Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction
title_short Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction
title_sort comparing the efficacy of postoperative pain control between intravenous parecoxib and oral diclofenac in acl reconstruction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532231/
https://www.ncbi.nlm.nih.gov/pubmed/34692879
http://dx.doi.org/10.1177/23259671211041660
work_keys_str_mv AT chuaychoosakoonchaiwat comparingtheefficacyofpostoperativepaincontrolbetweenintravenousparecoxibandoraldiclofenacinaclreconstruction
AT parinyakhupwachiraphan comparingtheefficacyofpostoperativepaincontrolbetweenintravenousparecoxibandoraldiclofenacinaclreconstruction
AT wiwatbowornarnan comparingtheefficacyofpostoperativepaincontrolbetweenintravenousparecoxibandoraldiclofenacinaclreconstruction
AT purngpiputtrakulpeeranut comparingtheefficacyofpostoperativepaincontrolbetweenintravenousparecoxibandoraldiclofenacinaclreconstruction
AT wanasitchaiwatpawin comparingtheefficacyofpostoperativepaincontrolbetweenintravenousparecoxibandoraldiclofenacinaclreconstruction
AT boonriongtanarat comparingtheefficacyofpostoperativepaincontrolbetweenintravenousparecoxibandoraldiclofenacinaclreconstruction