Monday , 8 August 2022

Assessment of Pain Relief and Tolerability of Cyclo-Oxygenase-2 Inhibitors as Post-Operative Analgesics

Sandeep Akkam*,C. Madhusudhan Chetty, D. Chinna Babu, N. Swaroop Reddy, Y. Chaitanya Kumar
Department of Pharmacy Practice, Santhiram college of Pharmacy, Nandyal, Andhra Pradesh, India.

Background and objectives: Pain is an unavoidable outcome of every surgery, and most of the time it is sub- optimally treated. Conventional postoperative analgesics are opioids and non-selective NSAIDs, which have moderate to severe adverse effects profile. Parecoxib is the only parenterally administered selective cyclooxygenase-2 inhibitor available. This study was done to assess the pain relief and tolerability of cyclooxygenase-2 specific inhibitor after giving first dose postoperatively. Method: This was a observational and comparative study between parecoxib 40 mg IV and diclofenac 75 mg IM as postoperative analgesic. After baseline score subsequent scores were taken at intervals of 30 minutes, 1, 4 and 8 hrs, after administering analgesic. Analgesic efficacy was assessed in terms of mean pain intensity score difference and tolerability assessment was done by monitoring general adverse events. Statistical analysis was done by using student‘t’ test with p< 0.05 as significant. Results: 40 patients were enrolled in the study, 20 patients in each group. Demographic data was similar between two groups. Mean pain intensity score at baseline was 3.35 and 3.36 in parecoxib and diclofenac group respectively. The difference in pain score between the groups were not statistically significant (p >0.05) in total 8 hours of study. Reduction in mean pain intensity upto 50 % was achieved in 30 min and 1 hr in parecoxib and diclofenac group respectively. At the end of 8 hours, 15 (75 %) patients in parecoxib group experienced ‘no pain’; while in diclofenac sodium group it was only with 8 (40 %) patients. Only mild adverse events like nausea, vomiting, and headache were present. Conclusion: The results of the study indicate that selective single dose of COX-2 inhibitor parecoxib sodium 40 mg IV is comparable to single dose of diclofenac sodium 75 mg IM Both the drugs are found to be equally and well tolerated as single dose postoperative analgesic.
Keywords: Parecoxib, Diclofenac, Cox-2inhibitor, PostoperativeAnanlgesic

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