Essex MN, et al. - The objective of this study is to evaluate the effectiveness and opioid-sparing impacts of parecoxib following major gastrointestinal surgeries. This study is the first to exhibit that multiple-dose parecoxib, initiated upon recovery from anesthesia, provides analgesia and opioid-sparing impacts following a variety of major gastrointestinal surgeries employing laparotomy.

Methods

• Patients in this analysis were a subset from a large, randomized, double-blind, placebo-controlled trial of parecoxib following noncardiac surgeries and consisted of those undergoing a variety of major gastrointestinal surgeries via laparotomy.
• Pain, pain interference with function, supplemental opioid use, opioid-related symptoms, and Patient/Physician Global Evaluation of Study Medication were compared between placebo and parecoxib groups in the 2-3 days following surgery.

Results

• There were significantly (p<0.001) lower pain scores in the parecoxib group (n=111), relative to placebo (n=126), on Day 2 (-33%) and Day 3 (-35%).
• In this study, pain interference with function scores was also significantly (p<0.001) lower among patients receiving parecoxib compared with placebo on Day 2 (-29%) and Day 3 (-36%).
• At 24, 48, and 72 hours, the cumulative amount of supplemental morphine consumed was 45%, 41%, and 40% less in patients receiving parecoxib compared with placebo (all p<0.001).
• The risk of experiencing ≥ 1 opioid-related symptoms was also significantly lower with parecoxib than with placebo on Day 2 (relative risk=0.75; p<0.001).
• In particular, the risks of fatigue and drowsiness were significantly (both p<0.05) lower in patients receiving parecoxib compared to those receiving placebo.
• As compared with the placebo group (p<0.001), patient and Physician Global Evaluation of Study Medication scores were significantly better in the parecoxib group.