Parecoxib versus Tramadol for Post-Appendectomy Pain
Wacharin Sindhvananda MD, MPH*, Pakorn Urusopone MD*, Pin Sriprajittichai MD*, Toonchai Indrambarya MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University
Open uncomplicated appendectomy is known for low to medium degree of postoperative pain and a short hospital stay. Based on multimodal pain therapy, non-opioid analgesics have widely been a part in pain control. Parecoxib and tramadol have advantages over traditional opioids that are causing less nausea or vomiting, respiratory depression and sedation. As a result, the authors aimed to compare parecoxib and tramadol regarding quality of pain control after open appendectomy. Fifty patients, underwent open appen- dectomy with spinal anesthesia, were randomized to receive either parecoxib or tramadol (n = 25 each). Parecoxib 40 mg and tramadol 50 mg IV were administered twice, when closing the peritoneum and at 12 h later. Doses of rescued meperidine for 24 h were recorded. Pain score, sedation, nausea or vomiting and satisfaction scores were assessed at 6, 12 and 24 h after operation. The mean rescued doses of meperidine were 4.6 + 10.9 and 18.6 + 21.0 mg in parecoxib and tramadol groups respectively (p = 0.005). There was a significantly higher pain score at 24 h (p = 0.01) and sedation score at 6 h (p = 0.003) in the tramadol group. Parecoxib provided a lower pain and sedation scores and lesser meperidine consumption than tramadol for post-appendectomy pain. Implication: Parecoxib, as a primary analgesic, is better in analgesia and has less sedation than tramadol for post-appendectomy pain.
Keywords : Analgesics, Parecoxib, Tramadol, Surgery, Appendectomy
