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Effect of short-term postoperative celecoxib administration on patient outcome after outpatient laparoscopic surgery

[Effet de l’administration postopératoire à court terme de célécoxib sur l’évolution des patients après une chirurgie par laparoscopie sans hospitalisation]

From the Department of Anesthesiology & Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.

Address correspondence to: Dr. Paul F. White, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-9068, USA. Phone: 214-648-6424; Fax: 214-648-2229; E-mail: paul.white{at}utsouthwestern.edu

Purpose: Non-opioid analgesics are increasingly used as part of a multimodal regimen for pain management. This prospective, randomized, double-blinded, placebo-controlled study was designed to evaluate the effect of short-term postoperative administration of celecoxib on pain management and recovery outcomes following laparoscopic surgery.

Methods: Eighty consenting ASA I–III outpatients undergoing laparoscopic surgery were randomly assigned to one of two treatment groups: Control (placebo) or Celecoxib (celecoxib, 400 mg·day^–1). The initial dose (celecoxib 400 mg or placebo po) was administered in the recovery room, and celecoxib 200 mg (or a placebo) po bid was continued for three additional days after surgery. Postoperative pain scores and the need for opioid- containing analgesics were recorded at specific intervals in the recovery room. Follow-up evaluations were performed at 24 hr, 48 hr, 72 hr and seven days and one month after surgery to assess post-discharge pain, analgesic requirements, complications, quality of recovery, and resumption of normal activities, as well as patient satisfaction with their pain management.

Results: Celecoxib reduced mean pain scores and the need for analgesics at 24 hr and 48 hr postoperatively. Patient satisfaction with their postoperative pain management was also higher in the Celecoxib group (94 ± 8 vs 80 ± 25, P < 0.05). Quality of recovery scores were significantly higher in the Celecoxib group on the first and second postoperative days (17 ± 1 vs 15 ± 2, and 18 ± 1 vs 16 ± 2, respectively). Finally, bowel function recovered an average of one day earlier and patients resumed activities of daily living two days earlier in the Celecoxib group (P < 0.05).

Conclusion: Short-term administration of celecoxib, 400 mg·day^–1 po, decreased postoperative pain and the need for opioid-containing analgesic medication, leading to an improved quality of recovery after outpatient laparoscopic surgery.

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