Clinical Investigation Of The Celecoxib's Multimodal Effects On The Postoperative Analgesia Of Orthopaedic Surgery

Objective:To evaluate the celecoxib's multimodal postoperative analgesia effects combined with PCA and its clinical efficacy and related adverse events in orthopaedic procedures.Methods:Prospective and comparative study of 60 patients(33 male, 27 female,age from 18 to 80,average 44.3 years old,)undergoing orthopaedic surgery,which were randomly divided into-2 groups: Observation Group received 400mg of celecoxib from POD0 to POD5 and 200mg until POD14 plus IV PCA(fentanyl 1.0mg/100ml)postoperatively; Control Group only took IV PCA postoperatively.Visual analogue scale(VAS)scores,PCA press times,cumulative volumes of the fentanyl were assessd every 4 hrs postoperatively until 48hrs.Sleep disturbance, vital signs including HR,RR,BP,SpO2 and side-effects including oversedation,nausea,emesis,pruritus and dyspnea were observed for 2 days.Blood-R test and coagulation function test were examed preoperatively and postoperatively on POD 1,3.Blood loss,satisfied score and chronic pain situation at 1 month were also measured.Result:VAS scores,sleep disturbance,PCA cumulative volumes of the fentany were found significant better in multimodal group compared with simple analgesia group(p＜0.05),the opioid related adverse effects morbidity was not statistically lower in the multimodal groups(p＞0.05). The observation group was more satisfied with analgesia treatment and experienced less pain after 1 month discharge(p＜0.05),the other datas appeared comparable between the groups(p＞0.05).Conclusion:The multimodal use of the specific COX-2 inhibitorcelecoxib in the postoperative period of orthopaedic procedures clearly improved postoperative pain,reduced the opioid consumption,released the sleep disturbances,demonstrated more satisfaction in patients and better chronic pain rate after discharge,without affecting the platelet and coagulation function.