The analgesic efficacy of valdecoxib vs. oxycodone/acetaminophen after oral surgery

Daniels, Stephen E.; Desjardins, Paul J.; Talwalker, Sheela; Recker, David P.; Verburg, Kenneth M.

doi:10.14219/jada.archive.2002.0237

Cited by 85 publications

(65 citation statements)

References 22 publications

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“…Valdecoxib has been assessed in clinical studies of analgesic efficacy after third molar removal (13,(25)(26)(27)(28)(29)(30). However, none of these studies used the surgical model employed in ours.…”

Section: Discussionmentioning

confidence: 99%

“…The following parameters were assessed: duration of the surgery after anesthetic administration (in minutes), which corresponded to the period between the first incision and the last suture (2,5,6); subjective postoperative pain evaluation with the aid of a 100-mm length visual analogue scale, with 0 corresponding to "no pain" and 100 corresponding to "worst pain imaginable" (5,6,13); subjects recorded the intensity of postoperative pain at 15-min intervals for the first 60 postoperative minutes, and 1.5, 2, 3, 4, 5, 6, 7, 8, 10, 12, 16, 24 (6,13,25), 48, 72, and 96 h (6) after the end of surgery; mouth opening (distance, in mm, between the mesial-incisal corners of the upper and lower right central incisors at maximum opening of the jaws) before surgery and at the time of suture removal (7 days postoperatively); the postoperative ability to open the mouth was expressed as a percentage of the preoperative measure (2,5,6); incidence, type and severity of adverse reactions (gastrointestinal irritation, nausea, vomiting, bleeding, allergy, headache, dizziness, sleepiness, and any other kinds of reaction) (5,6,13); total amount of rescue analgesic medication (paracetamol, in mg) needed during the postoperative period, and facial swelling determined by a tape-measuring method on the 2nd and 7th postoperative days (2). This method takes V. Benetello et al…”

Section: Methodsmentioning

confidence: 99%

“…COX-2 is believed to be the main isoenzyme for pro-inflammatory prostaglandin production (7). Thus, despite their high cost, COX-2 selective inhibitors such as coxibs have been extensively used in order to selectively inhibit COX-2, but not COX-1, resulting in therapeutic effects comparable with those of conventional NSAIDS, but with less adverse reactions for patients (7,13). It is worth mentioning that recent reports have suggested an increased risk of cardiovascular events for patients taking coxibs.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, there are only seven reports in the dental literature concerning the clinical use of valdecoxib, a COX-2 selective inhibitor, for postoperative pain control in patients who undergo dental surgeries (13,(25)(26)(27)(28)(29)(30). In these studies, either different doses of valdecoxib or its injectable prodrug parecoxib were tested (9,16,17,19) or a comparison with rofecoxib, another COX-2 selective inhibitor, was performed (25,28,30).…”

Section: Introductionmentioning

confidence: 99%

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The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

Benetello

Sakamoto

Giglio

et al. 2007

Braz J Med Biol Res

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We compared the clinical efficacy of orally administered valdecoxib and piroxicam for the prevention of pain, trismus and swelling after removal of horizontally and totally intrabony impacted lower third molars. Twenty-five patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Valdecoxib (40 mg) or piroxicam (20 mg) was administered in a double-blind, randomized and crossed manner for 4 days after the surgical procedures. Objective and subjective parameters were recorded for comparison of postoperative courses. Both agents were effective for postoperative pain relief (N = 19). There was a similar mouth opening at suture removal compared with the preoperative values (86.14 ± 4.36 and 93.12 ± 3.70% of the initial measure for valdecoxib and piroxicam, respectively; ANOVA). There was no significant difference regarding the total amount of rescue medication taken by the patients treated with valdecoxib or piroxicam (173.08 ± 91.21 and 461.54 ± 199.85 mg, respectively; Wilcoxon test). There were no significant differences concerning the swelling observed on the second postoperative day compared to baseline measures (6.15 ± 1.84 and 8.46 ± 2.04 mm for valdecoxib and piroxicam, respectively; ANOVA) or on the seventh postoperative day (1.69 ± 1.61 and 2.23 ± 2.09 mm for valdecoxib and piroxicam, respectively; ANOVA). The cyclooxygenase-2 selective inhibitor valdecoxib is as effective as the non-selective cyclooxygenase inhibitor piroxicam for pain, trismus and swelling control after removal of horizontally and totally intrabony impacted lower third molars.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

Benetello

Sakamoto

Giglio

et al. 2007

Braz J Med Biol Res

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“…Pooled safety data demonstrated that valdecoxib had a tolerability profile superior to that of the oxycodone ⁄ acetaminophen combination and similar to that of placebo. 24 The efficacy of a single dose of 40 mg valdecoxib has been compared with 50 mg rofecoxib and placebo in a randomized, double-blind, placebo-controlled clinical trial in 203 patients with moderate to severe pain following the extraction of two or more third molars with bone removal. 25 After surgery, patients received a single dose of 40 mg valdecoxib (n ¼ 80), 50 mg rofecoxib (n ¼ 82) or placebo (n ¼ 41).…”

Section: Oral Surgerymentioning

confidence: 99%

The pharmacological properties and clinical use of valdecoxib, a new cyclo‐oxygenase‐2‐selective inhibitor

Alsalameh

Burian

Mahr

et al. 2003

Aliment Pharmacol Ther

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SUMMARYCyclo-oxygenase-2-selective inhibitors produce less gastric damage than conventional non-steroidal antiinflammatory drugs. Valdecoxib is a new orally administered cyclo-oxygenase-2-selective inhibitor, recently approved for use in osteoarthritis, rheumatoid arthritis and primary dysmenorrhoea in the USA. The drug has been evaluated in more than 60 clinical studies involving more than 14 000 patients and healthy volunteers. The analgesic efficacy of valdecoxib at a dose of 10 mg once daily in both osteoarthritis and rheumatoid arthritis is superior to that of placebo and similar to that of traditional non-steroidal anti-inflammatory drugs. Valdecoxib is effective in single doses of up to 40 mg for the alleviation of acute menstrual pain and has a rapid onset of action (within 30 min) and a long duration of analgesia (up to 24 h). Valdecoxib is well tolerated and has safety advantages compared with traditional non-steroidal anti-inflammatory drugs in terms of less gastrointestinal toxicity and a lack of an effect on platelet function. The incidence of adverse effects involving the kidney (fluid retention, oedema and hypertension) is similar to that of non-selective, nonsteroidal anti-inflammatory drugs.

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Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults

Gaskell

Derry²,

Moore³

et al. 2009

Cochrane Database of Systematic Reviews

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Background Oxycodone is a strong opioid agonist used to treat severe pain. It is commonly combined with milder analgesics such as paracetamol. This review updates a previous review that concluded, based on limited data, that all doses of oxycodone exceeding 5 mg, with or without paracetamol, provided analgesia in postoperative pain, but with increased incidence of adverse events compared with placebo. Additional new studies provide more reliable estimates of efficacy and harm. Objectives To assess efficacy, duration of action, and associated adverse events of single dose oral oxycodone, with or without paracetamol, in acute postoperative pain in adults. Search methods Cochrane CENTRAL, MEDLINE, EMBASE and Oxford Pain Relief Database, searched in May 2009. Selection criteria Randomised, double blind, placebo-controlled trials of single dose orally administered oxycodone, with or without paracetamol, in adults with moderate to severe acute postoperative pain. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Pain relief or pain intensity data were extracted and converted into the dichotomous outcome of number of participants with at least 50% pain relief over 4 to 6 hours, from which relative risk and number-needed-to-treat-to-benefit (NNT) were calculated. Numbers of participants remedicating over specified time periods, and time-to-use of rescue medication, were sought as additional measures of efficacy. Adverse events and withdrawals information was collected. Main results This updated review includes 20 studies, with 2641 participants. For oxycodone 15 mg alone compared with placebo, the NNT for at least 50% pain relief was 4.6 (95% Confidence Interval 2.9 to 11). For oxycodone 10 mg plus paracetamol 650 mg, the NNT was 2.7 (2.4 to 3.1). A dose response was demonstrated for this outcome with combination therapy. Duration of effect was 10 hours with oxycodone 10 mg plus paracetamol 650 mg, and 4 hours with half that dose. Fewer participants needed rescue medication over 6 hours at the higher dose. Adverse events occurred more frequently with combination therapy than placebo, but were generally described as mild to moderate in severity and rarely led to withdrawal. Authors’ conclusions Single dose oxycodone is an effective analgesic in acute postoperative pain at doses over 5 mg; oxycodone is two to three times stronger than codeine. Efficacy increases when combined with paracetamol. Oxycodone 10 mg plus paracetamol 650 mg provides good analgesia to half of those treated, comparable to commonly used non-steroidal anti-inflammatory drugs, with the benefit of longer duration of action.

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The analgesic efficacy of valdecoxib vs. oxycodone/acetaminophen after oral surgery

Cited by 85 publications

References 22 publications

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

The pharmacological properties and clinical use of valdecoxib, a new cyclo‐oxygenase‐2‐selective inhibitor

Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults

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