Treatment with parenteral parecoxib followed by oral valdecoxib after major general surgery reduces opioid consumption and opioid-related adverse effects

Parecoxib sodium administered over several days reduces pain after gynecologic surgery via laparotomy

“…In contrast, in studies of patients undergoing laparoscopic cholecystectomy [7] or general surgery [12], reduced opioid use and reduced opioid-related symptoms have been reported in the parecoxib treatment group.…”

<p>A cost-consequence analysis of parecoxib and opioids vs opioids alone for postoperative pain: Chinese perspective</p>

“…Safety and efficacy outcomes of the clinical trial have been reported previously 12,14,15. Parecoxib reduced SPI scores over 3 days by 21.6 (59.2 vs 80.8 for opioids alone, P <0.01).…”

“…Given the large uncertainty surrounding the treatment patterns and costs of CMEs, a probabilistic analysis was also undertaken taking into account the variability between responses of the expert panel regarding additional costs of CMEs for individual resource items (variability as shown in Table 1) and the variability of pain medication use and occurrence of CMEs as reported previously from the pivotal trial 12,14,15. The probabilistic estimate of the cost-saving provided by parecoxib was ¥374, with a 95% CI of between parecoxib costing more than opioids alone by ¥66 and savings of up to ¥1,030 (Table 2).…”

“…Ten opioid-related symptoms were assessed: fatigue, drowsiness, inability to concentrate, confusion, dizziness, constipation, itching, difficulty with urination, nausea, and vomiting. Clinically meaningful events (CMEs)14,15 related to opioid use were defined as OR-SDS symptoms judged to be on the upper distress continuum for severity (ie, it was “severe” or “very severe,” with the exception of confusion which was considered to be a CME with a severity between “moderate” and “very severe”) 16. Additional analyses of the trial data showed that patients treated with parecoxib and opioids had a significantly lower risk of experiencing opioid-related CMEs than patients treated with opioids alone 14,15…”

“…The economic impact of adding parecoxib to opioid treatment against opioid-only analgesia was evaluated in the UK17 and Greece18 by using a cost-consequence model, which incorporated resource use, costs, and clinical outcomes for 3 days following noncardiac surgery. The reduction in opioid-associated CMEs with parecoxib12,14,15 resulted in shorter hospital stays and a reduced need for physician and nurse time in the models. Subsequently, the excess drug cost of adding parecoxib to opioid treatment was offset by the decrease in CME-related costs, which suggested cost savings for both the UK and Greek health care systems compared with opioid use alone.…”