PMID- 24672093
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140327
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 65
IP  - 5
DP  - 2004 Sep
TI  - Comparison of the effects of parecoxib and diclofenac in preemptive analgesia: A 
      prospective, randomized, assessor-blind, single-dose, parallel-group study in 
      patients undergoing elective general surgery.
PG  - 383-97
LID - 10.1016/j.curtheres.2004.10.004 [doi]
AB  - BACKGROUND: Preoperative administration of analgesics may prevent or 
      reducehyperalgesia, inhibit inflammation, and reduce pain by reducing the 
      synthesis of prostaglandins in response to tissue damage caused by surgery. 
      Nonsteroidal anti-inflammatory drugs (NSAIDs) are a potent, widely used class of 
      analgesic agents; however, they may not be as effective as selective 
      cyclooxygenase (COX)-2 inhibitors. OBJECTIVE: The aim of this study was to 
      compare the efficacy and tolerabilityof the COX-2 inhibitor parecoxib sodium and 
      the NSAID diclofenac sodium as preemptive analgesics in patients undergoing 
      elective general surgery. METHODS: This was a prospective, randomized, 
      assessor-blind, single-dose,parallel-group, comparative trial. Patients aged 18 
      to 65 years undergoing elective general surgery were enrolled. A single IM 
      injection of parecoxib 40 mg or diclofenac 75 mg was administered 30 to 45 
      minutes before the induction of anesthesia. Surgery was performed as per standard 
      protocol. The primary measures of efficacy were pain intensity score (measured on 
      a visual analog scale [VAS]), pain relief score, duration of analgesia, and 
      platelet aggregation response to adenosine diphosphate. Tolerability assessment 
      included monitoring of treatment-emergent adverse events (AEs), physical 
      examination, laboratory analysis, electrocardiography, and chest radiography. 
      RESULTS: Eighty patients (56 men, 24 women; mean [SD] age, 45.96 [12.83] years) 
      were enrolled in the study (40 patients per treatment group). All patients 
      completed the trial. No pain was reported by any patient in the parecoxib group 
      up to 12 hours; in the diclofenac group, no pain was reported up to 6 hours. At 
      12 hours, the mean (SD) VAS score was 2.33 (1.39) (moderate pain) in the 
      diclofenac group and 0 (no pain) in the parecoxib group (P < 0.05). At 12 hours, 
      total pain relief was reported by all 40 patients (100.0%) in the parecoxib group 
      but by none (0.0%) in the diclofenac group, and 2 patients in the diclofenac 
      group (5.0%) reported good pain relief (between-group difference for total + good 
      pain relief, P < 0.05). Mean (SD) duration of analgesia was significantly longer 
      in the parecoxib group than in the diclofenac group (19.48 [5.61] hours vs 8.32 
      [4.11 ] hours; P < 0.05). Platelet aggregation was significantly inhibited in the 
      diclofenac group (change from baseline, 64.0%) but not in the parecoxib group 
      (change from baseline, 12.0%) (P < 0.05). Both regimens were well tolerated, and 
      no AEs were reported. CONCLUSIONS: In this study of patients undergoing elective 
      general surgery,patients treated with the COX-2 specific inhibitor parecoxib 
      experienced no pain at 12 hours, and the treatment was well tolerated. The 
      results of this study suggest that good postoperative analgesia and minimal 
      interference with platelet function may make parecoxib an alternative to the 
      nonselective NSAID diclofenac in providing preemptive analgesia in patients 
      undergoing general surgery.
FAU - Bajaj, Parina
AU  - Bajaj P
AD  - Department of Surgery, Grant Medical College and Sir JJ Group of Hospitals, 
      Mumbai, India.
FAU - Ballary, Chetna C
AU  - Ballary CC
AD  - Medical Services Department, Glenmark Pharmaceuticals Ltd., Mumbai, India.
FAU - Dongre, Neelesh A
AU  - Dongre NA
AD  - Medical Services Department, Glenmark Pharmaceuticals Ltd., Mumbai, India.
FAU - Baliga, Vidyagauri P
AU  - Baliga VP
AD  - Medical Services Department, Glenmark Pharmaceuticals Ltd., Mumbai, India.
FAU - Desai, Anish A
AU  - Desai AA
AD  - Medical Services Department, Glenmark Pharmaceuticals Ltd., Mumbai, India.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3964533
OTO - NOTNLM
OT  - diclofenac
OT  - general surgery
OT  - parecoxib
OT  - preemptive analgesia
OT  - valdecoxib
EDAT- 2004/09/01 00:00
MHDA- 2004/09/01 00:01
PMCR- 2004/09/01
CRDT- 2014/03/28 06:00
PHST- 2004/08/02 00:00 [accepted]
PHST- 2014/03/28 06:00 [entrez]
PHST- 2004/09/01 00:00 [pubmed]
PHST- 2004/09/01 00:01 [medline]
PHST- 2004/09/01 00:00 [pmc-release]
AID - S0011-393X(04)80118-8 [pii]
AID - 10.1016/j.curtheres.2004.10.004 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2004 Sep;65(5):383-97. doi: 
      10.1016/j.curtheres.2004.10.004.