15 November 2018 : Clinical Research
Evaluation of Intravenous Parecoxib Infusion Pump of Patient-Controlled Analgesia Compared to Fentanyl for Postoperative Pain Management in Laparoscopic Liver Resection
Yufeng Liu1ABCDEF, Xuan Song1BCD, Dan Sun1BD, Jiabei Wang1CD, Yaliang Lan1BEF, Guangchao Yang1BC, Fanzheng Meng1BF, Yan Wang1CD, Yifeng Cui1BC, Bo Zhang1BD, Xianying Li1EF, Lianxin Liu1AG*DOI: 10.12659/MSM.913182
Med Sci Monit 2018; 24: CLR8224-8231
Abstract
BACKGROUND: As laparoscopic liver resection is becoming a commonly used method for hepatic surgery, postoperative pain management is emerging as one of the trickiest problems after surgery. The ideal method of pain management is controversial and the optimal strategy for postoperative pain management after surgery remains unclear. The present study evaluated the postoperative analgesic efficacy of parecoxib and fentanyl, and the benefit of a new intravenous parecoxib infusion pump with patient-controlled analgesia after laparoscopic liver resection.
MATERIAL AND METHODS: This controlled, prospective, randomized, double-blind trial compared VAS scores among 3 groups of patients: a fentanyl group (FEN group) using a fentanyl citrate pump, an intravenous parecoxib group (IVPA group) receiving intravenous parecoxib, and a parecoxib pump group (PUPA group) receiving parecoxib sodium by analgesia pump. We enrolled 124 patients planned for laparoscopic liver resection. The primary outcome was VAS score at rest and with movement. Secondary outcomes were adverse effects (including nausea), sedation, pruritus, and quality of life.
RESULTS: For all time intervals, the VAS scores were significantly lower in the PUPA group. VAS scores at rest and with movement in the PUPA group were the lowest among the 3 groups, while the scores in the FEN group were the highest. More adverse effects were detected in the FEN group, and no significant differences in adverse effects were found between the intravenous group and the parecoxib pump group.
CONCLUSIONS: Use of the intravenous infusion parecoxib pump for patient-controlled analgesia provides superior analgesic efficacy and fewer adverse effects for patients after laparoscopic liver resection.
Keywords: Analgesia, Anti-Inflammatory Agents, Non-Steroidal, Laparoscopy
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