INTRAVENOUS PARECOXIB SODIUM HAS OPIOID SPARING EFFECT IN PATIENTS UNDERGOING MAJOR GYNAECOLOGICAL SURGERY UNDER SPINAL ANAESTHESIA

This double blind, placebo controlled study, compared the opioid sparing effectiveness, analgesic efficacy and safety of intravenous parecoxib sodium over 24 hours in 100 ASA I and II postoperative patients after major gynaecological surgery, performed under subarachnoid block with single dose of bupivacaine, 15- 20 mg and intraoperative sedation with midazolam 1- 2 mg I. V. Patients were randomized to receive either parecoxib sodium 40 mg (group A, n = 50), or 2 ml normal saline I. V. as placebo (group B, n = 50) at the end of surgery. Both the groups along with the study medication received intramuscular pethidine hydrochloride 1 mgkg(-1) at the same time after the end of surgery. The same dose of pethidine was repeated if patient complained of pain during 24 hours in the postoperative period. It was observed that patients receiving parecoxib sodium (group A) consumed 40% less pethidine (90.05 mg) during 24 hours postoperatively than the patients given placebo (group B - 150.02 mg) p< 0.05. Patient receiving parecoxib sodium experienced significantly greater pain relief compared to placebo group during 24 hrs in the postoperative period, p< 0.005. An evaluation of study medication demonstrated a greater level of satisfaction among patients taking parecoxib sodium than those taking placebo at the end of 24 hrs. Side effects in the form of vomiting were recorded in a very few patient in both the groups and the result was not significant. Administration of parecoxib sodium with intramuscular pethidine hydrochloride resulted in significantly improved postoperative analgesia as defined by reduction in opioid requirement, lower pain scores, higher global evaluation rating and less side effects.