Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation
Adequacy of postoperative pain control is one of the most important factors in determining when a patient can be safely discharged from a surgical facility. Furthermore, it has a major influence on the patient’s ability to resume the normal activities of daily living. Tramadol is a weak opioid analg...
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Confederation of ASEAN Societies of Anaesthesiologists
2007
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my.iium.irep.112972021-01-27T08:29:00Z http://irep.iium.edu.my/11297/ Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Md Ralib, Azrina Abd. Wahab, Noraziana Mat Nor, Mohd Basri R Medicine (General) RG Gynecology and obstetrics Adequacy of postoperative pain control is one of the most important factors in determining when a patient can be safely discharged from a surgical facility. Furthermore, it has a major influence on the patient’s ability to resume the normal activities of daily living. Tramadol is a weak opioid analgesic that acts mainly on μ-opioid receptor and has been proven to provide effective and safe analgesic to post-operative patients. Celecoxib (celebrex) is a highly selective COX-2 inhibitor. It belongs to nonsteroidal anti-inflammatory drugs (NSAIDs) group which reduces inflammation and pain while minimizing gastrointestinal adverse reaction. This selectivity feature makes celecoxib an attractive alternative to opioids for the control of postoperative pain. The purpose of this study was to evaluate the effectiveness of oral celecoxib, in comparison with oral tramadol, in term of analgesic properties and the need for additional tablet acetaminophen as rescue pain reliever in patients undergoing elective gynecological operation. A randomized, single-blinded study was conducted on 100 ASA I and II patients who were randomized into two groups: tramadol or celecoxib. Following major gynaecological surgery, all patients were given standard patient-controlled analgesia (PCA) regime with intravenous morphine. Patients either received oral tramadol 100 mg 8 hourly or oral celecoxib 200mg 12 hourly for analgesia 24 hours post operation. Tablet acetaminophen was available as a rescue analgesic. Patients were monitored for pain according to Modified Pain Score, haemodynamic changes and side effects. They were evaluated at 24, 32, 40 and 48 hours post operation. The mean pain score at 24, 32, 40 and 48 hours post operation were 0.86 ± 0.45, 0.68 ± 0.47, 0.42 ± 0.50, and 0.14 ± 0.35 in celecoxib group and 0.92 ± 0.44, 0.78 ± 0.41, 0.46 ± 0.54 and 0.18 ± 0.39 in tramadol group respectively. There were no significant differences in the mean pain score and between the two groups at each point of assessment (p>0.05). None of the patients requested for tablet acetaminophen. Patient satisfaction was similar in both study groups. This study indicates that oral celecoxib 200 mg 12 hourly is adequate and suitable to be used as an alternative to oral tramadol 100 mg 8 hourly in controlling pain 24 hours following major operation without the need for additional tablet acetaminophen. Confederation of ASEAN Societies of Anaesthesiologists 2007-05 Article PeerReviewed application/pdf en http://irep.iium.edu.my/11297/1/AsJournVol8May07.pdf application/pdf en http://irep.iium.edu.my/11297/4/AsJournVol8May07_content.pdf Mohamed, Rozilah @ Abdul Hadi and Abdullah, Nor Zamzila and Md Ralib, Azrina and Abd. Wahab, Noraziana and Mat Nor, Mohd Basri (2007) Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation. ASEAN Jounal of Anaesthesiology, 8 (1). pp. 59-65. |
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R Medicine (General) RG Gynecology and obstetrics Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Md Ralib, Azrina Abd. Wahab, Noraziana Mat Nor, Mohd Basri Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation |
| description |
Adequacy of postoperative pain control is one of the most important factors in determining when a patient can be safely discharged from a surgical facility. Furthermore, it has a major influence on the patient’s ability to resume the normal activities of daily living. Tramadol is a weak opioid analgesic that acts mainly on μ-opioid receptor and has been proven to provide effective and safe analgesic to post-operative patients.
Celecoxib (celebrex) is a highly selective COX-2 inhibitor. It belongs to nonsteroidal anti-inflammatory drugs
(NSAIDs) group which reduces inflammation and pain while minimizing gastrointestinal adverse reaction.
This selectivity feature makes celecoxib an attractive alternative to opioids for the control of postoperative
pain.
The purpose of this study was to evaluate the effectiveness of oral celecoxib, in comparison with oral
tramadol, in term of analgesic properties and the need for additional tablet acetaminophen as rescue pain
reliever in patients undergoing elective gynecological operation.
A randomized, single-blinded study was conducted on 100 ASA I and II patients who were randomized
into two groups: tramadol or celecoxib. Following major gynaecological surgery, all patients were given
standard patient-controlled analgesia (PCA) regime with intravenous morphine. Patients either received oral
tramadol 100 mg 8 hourly or oral celecoxib 200mg 12 hourly for analgesia 24 hours post operation. Tablet
acetaminophen was available as a rescue analgesic. Patients were monitored for pain according to Modified
Pain Score, haemodynamic changes and side effects. They were evaluated at 24, 32, 40 and 48 hours post
operation. The mean pain score at 24, 32, 40 and 48 hours post operation were 0.86 ± 0.45, 0.68 ± 0.47,
0.42 ± 0.50, and 0.14 ± 0.35 in celecoxib group and 0.92 ± 0.44, 0.78 ± 0.41, 0.46 ± 0.54 and 0.18 ± 0.39 in
tramadol group respectively. There were no significant differences in the mean pain score and between the
two groups at each point of assessment (p>0.05). None of the patients requested for tablet acetaminophen.
Patient satisfaction was similar in both study groups.
This study indicates that oral celecoxib 200 mg 12 hourly is adequate and suitable to be used as an
alternative to oral tramadol 100 mg 8 hourly in controlling pain 24 hours following major operation without
the need for additional tablet acetaminophen.
|
| format |
Article |
| author |
Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Md Ralib, Azrina Abd. Wahab, Noraziana Mat Nor, Mohd Basri |
| author_facet |
Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Md Ralib, Azrina Abd. Wahab, Noraziana Mat Nor, Mohd Basri |
| author_sort |
Mohamed, Rozilah @ Abdul Hadi |
| title |
Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation |
| title_short |
Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation |
| title_full |
Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation |
| title_fullStr |
Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation |
| title_full_unstemmed |
Oral Analgesia 24 hours after major operation: A Comparative Study Of Oral Calecoxib and Tramadol in Patients Undergoing Major Gynaecological Operation |
| title_sort |
oral analgesia 24 hours after major operation: a comparative study of oral calecoxib and tramadol in patients undergoing major gynaecological operation |
| publisher |
Confederation of ASEAN Societies of Anaesthesiologists |
| publishDate |
2007 |
| url |
http://irep.iium.edu.my/11297/1/AsJournVol8May07.pdf http://irep.iium.edu.my/11297/4/AsJournVol8May07_content.pdf http://irep.iium.edu.my/11297/ |
| _version_ |
1690370681044205568 |
| score |
13.211869 |