Is celecoxib a useful adjunct in the treatment of post-tonsillectomy pain in the adult population? A randomised, double-blind, placebo-controlled study

Ng, T. T.; Diamantaras, D; Priestley, Jennifer L.; Redman, J. W.; Silva, N De; Mahanta, Vibhuti

doi:10.1017/s0022215116009476

Cited by 19 publications

(30 citation statements)

References 37 publications

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“…25 mg) rofecoxib did not decrease morphine use or improve pain scores prior to hospital discharge in 45 pediatric patients. Ng et al [70] have evaluated the efficacy and safety of celecoxib for pain management in post-tonsillectomy adult patients with a randomised, double-blind, placebo-controlled study. Their conclusion was that celecoxib usage was associated with significantly more vomiting without reducing narcotic analgesia requirement post-tonsillectomy.…”

Section: Selective Platelet Cyclooxygenase Inhibitormentioning

confidence: 99%

Update review of pain control methods of tonsil surgery

et al. 2020

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Section: Selective Platelet Cyclooxygenase Inhibitormentioning

confidence: 99%

Update review of pain control methods of tonsil surgery

et al. 2020

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“…51 Patients undergoing adenotonsillectomy were included in two studies. 28,33 In the remaining studies, all patients underwent tonsillectomy. Surgery was performed under general anaesthesia in 27 studies; in two studies the type of anaesthesia was not reported.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Patients in one study received dexamethasone in addition to study medication. 33 Additional preoperative or postoperative analgesics were given in 13 studies, no additional analgesics were given in 10 studies, and information was not provided in six studies (Table 1). Rescue analgesics were given in 25 studies, were not allowed in one study, 37 and information was not provided in three studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Rescue analgesics were given in 25 studies, were not allowed in one study, 37 and information was not provided in three studies. 34,43,51 Study medications were administered before operation in eight studies, 29e31,45e49 before operation and intraoperatively in one study, 44 intraoperatively in seven studies, 8,26,34,35,38,43,50 intraoperatively and after operation in five studies, 27,32,36,37,39 after operation in seven studies, 23e25, 33,40,41,51 and before and after operation in one study. 44 One study compared intraoperative and postoperative administration of the study medication with placebo.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…intraoperatively and after operation 32 reduced pain and the need for rescue analgesia within 24 h. Oral rofecoxib 50 mg before operation decreased the incidence of pain (VAS>5) and the need for opioids within the first 8 h. 29 Celecoxib 200 mg twice daily for 1e10 postoperative days with additional paracetamol 1 g four times daily did not reduce pain or need for opioids. 33 The majority of patients given NSAIDs (74%) or placebo (85%) needed rescue analgesia within 24 h after the operation (relative risk [RR] 0.91 [95% CI 0.79e1.05], P¼0.21). 27,28,30e32 Six studies 27,28,30e33 reported incidence of PTH; none found an increased risk.…”

Section: Records Of Studies Idenɵfiedmentioning

confidence: 99%

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Systematic review of analgesics and dexamethasone for post-tonsillectomy pain in adults

Tolska

Hamunen

Takala

et al. 2019

British Journal of Anaesthesia

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Background: Intense pain can last several days after tonsillectomy. It is often undertreated and improved analgesic strategies that can be safely used at home are needed. Methods: We conducted a systematic review and meta-analysis on the effectiveness of systemic medications used for post-tonsillectomy pain in adult and adolescent (13 yr old) patients. Studies were identified from PubMed, the Cochrane Library, and by hand searching reference lists from studies and review articles. Randomised, double-blind, placebocontrolled studies reporting on pain intensity or use of rescue analgesia were included. Results: Twenty-nine randomised controlled trials representing 1816 subjects met the inclusion criteria. Follow-up time was 24 h in 15 studies, in which the majority were taking nonsteroidal anti-inflammatory drugs. Thirteen studies were suitable for meta-analysis. In pooled analysis, paracetamol, dexamethasone, and gabapentinoids reduced pain intensity on the day of operation. In individual studies, ketoprofen, ibuprofen, lornoxicam, parecoxib, rofecoxib, indomethacin and dextromethorphan reduced pain intensity, need for rescue analgesics, or both on the day of operation. Oral celecoxib for 2 postoperative weeks or i.v. ketamine on the day of operation were not effective at the studied doses. Dexamethasone in multiple doses provided analgesia beyond 1 postoperative day. Pain was moderate to strong in both study and control groups during the first postoperative week. Conclusions: Single analgesics and dexamethasone provide only a weak to moderate effect for post-tonsillectomy pain on the day of operation and thus a multimodal analgesic strategy is recommended. Short follow-up times and clinical heterogeneity of studies limit the usefulness of results. Editor's key pointsThe authors performed a systematic review and metaanalysis of pain management after tonsillectomy. Data were scarce and postoperative follow-up was short in the majority of studies. Paracetamol, NSAIDs, dexamethasone, gabapentinoids, and dextromethorphan showed weak to moderate analgesic effects on the day of operation.The authors suggest that multimodal analgesia is needed after tonsillectomy, and that further research on post-tonsillectomy pain is required, with follow-up over at least 1 week.

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Comparison of celecoxib and acetaminophen for pain relief in pediatric day case tonsillectomy: A randomized double‐blind study

Faramarzi

Roosta

Eghbal

et al. 2021

Laryngoscope Investig Oto

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Objective Post‐tonsillectomy pain is a common morbidity in children. The aim of this study was to compare the efficacy of celecoxib with acetaminophen on pain relief in pediatric day‐case tonsillectomy. Methods We compared the analgesic effect of celecoxib (99 patients) with acetaminophen (100 patients) for the management of post‐tonsillectomy pain. Post‐tonsillectomy pain score was evaluated three times a day for 7 days. In addition, the incidence of post‐tonsillectomy bleeding and the rate of patients who returned to regular diet were evaluated. Results In the first day, we observed lower mean pain score in the celecoxib group, than the acetaminophen group (P = 0.013). The overall pain score in other days was not significantly different between the two groups. In the celecoxib group, more patients resumed regular amount of oral intake within the first 3 days. Also, the rate of post‐tonsillectomy bleeding in the two groups was not statistically different. Conclusion We recommend celecoxib as a more suitable choice than acetaminophen for post‐tonsillectomy pain management in the first day and resuming regular diet within 3 days. Level of Evidence: 1b.

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Is celecoxib a useful adjunct in the treatment of post-tonsillectomy pain in the adult population? A randomised, double-blind, placebo-controlled study

Abstract: Celecoxib usage was associated with significantly more vomiting and did not reduce narcotic analgesia requirement post-tonsillectomy.

Cited by 19 publications

References 37 publications

Update review of pain control methods of tonsil surgery

Update review of pain control methods of tonsil surgery

Systematic review of analgesics and dexamethasone for post-tonsillectomy pain in adults

Comparison of celecoxib and acetaminophen for pain relief in pediatric day case tonsillectomy: A randomized double‐blind study

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