Nikanne Elina, Kokki Hannu, Salo Juha, Linna Timo-Jussi
Department of Otorhinolaryngology, Central Hospital, Finland.
Otolaryngol Head Neck Surg. 2005 Feb;132(2):287-94. doi: 10.1016/j.otohns.2004.09.005.
To evaluate the efficacy and safety of celecoxib and ketoprofen in pain management during tonsillectomy in 120 patients.
The study was randomized, double-blind, and placebo-controlled with parallel groups. Sixty minutes before anesthesia induction and 12 hours after, the patients received a 200-mg celecoxib, a 100-mg ketoprofen, or a placebo capsule. After discharge, patients were prescribed either celecoxib or ketoprofen capsules to be taken every 12 hours.
During the first 24 hours, the need for rescue analgesic was less in the ketoprofen-group (5 [1-9]) doses (median [range]) than in the placebo-group (6 [1-13]) ( P = 0.021), but similar to the celecoxib-group (5 [2-14]). After discharge, the cessation of pain during eating occurred earlier in the celecoxib-treated patients, after 10 (1-17) days, than in the ketoprofen-treated patients, after 12 (1-21) days, ( P = 0.008). One celecoxib-treated patient and 6 ketoprofen-treated patients ( P = 0.013) needed electrocautery to stop postoperative bleeding.
Ketoprofen provided a better initial analgesic efficacy but after discharge the recovery with celecoxib was faster and the incidence of secondary hemorrhages was lower.
Celecoxib seems to be more effective and safe than ketoprofen for pain management after discharge in patients with tonsillectomy.
评估塞来昔布和酮洛芬在120例扁桃体切除术中疼痛管理的疗效和安全性。
本研究为随机、双盲、安慰剂对照的平行组研究。在麻醉诱导前60分钟和诱导后12小时,患者分别接受200毫克塞来昔布、100毫克酮洛芬或安慰剂胶囊。出院后,患者被开了塞来昔布或酮洛芬胶囊,每12小时服用一次。
在最初的24小时内,酮洛芬组(5[1 - 9])剂量(中位数[范围])的急救镇痛需求低于安慰剂组(6[1 - 13])(P = 0.021),但与塞来昔布组(5[2 - 14])相似。出院后,塞来昔布治疗的患者在进食时疼痛停止的时间更早,为10(1 - 17)天,而酮洛芬治疗的患者为12(1 - 21)天(P = 0.008)。1例塞来昔布治疗的患者和6例酮洛芬治疗的患者(P = 0.013)需要电灼来停止术后出血。
酮洛芬提供了更好的初始镇痛效果,但出院后塞来昔布的恢复更快,继发性出血的发生率更低。
对于扁桃体切除术后出院患者的疼痛管理,塞来昔布似乎比酮洛芬更有效和安全。