Sekiguchi Hiroyuki, Inoue Gen, Nakazawa Toshiyuki, Imura Takayuki, Saito Wataru, Uchida Kentaro, Miyagi Masayuki, Takahira Naonobu, Takaso Masashi
Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
J Orthop Sci. 2015 Jul;20(4):617-23. doi: 10.1007/s00776-015-0726-4. Epub 2015 Apr 25.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to treat inflammation, pain, and fever, but no criterion standard exists for the management of postoperative pain following spinal surgery. In the present study, we compared the analgesic efficacy of loxoprofen sodium (loxoprofen) and celecoxib for the management of postoperative pain following spinal surgery.
One-hundred forty-one patients (mean age 62.2 years) were randomly assigned to two groups before spinal surgery: a loxoprofen group (n = 73, 180 mg/day) and a celecoxib group (n = 68, 200 mg/day). The drugs were administered from 1 day until 7 days after surgery. A numeric rating scale (NRS) was used to evaluate pain at nine predefined times every day and the findings were compared between the two groups. Laboratory data and adverse events were also recorded.
There was no significant difference in the maximum and mean NRS scores on each day between loxoprofen and celecoxib, suggesting a comparable analgesic effect for these two NSAIDs. Greater improvement in the NRS score between preadministration (baseline) and 30 min or 2 h after administration was obtained for loxoprofen. This tendency was shown for both slight (NRS score <5 at baseline) and severe pain (NRS score ≥ 5 at baseline). Loxoprofen was discontinued in one patient on day 4 because of renal dysfunction. Celecoxib was discontinued in one patient on day 2 at the patient's request.
Both loxoprofen sodium and celecoxib were well tolerated for the relief of acute postoperative pain after spinal surgery. A single administration of loxoprofen showed superior and rapid effectiveness compared with celecoxib for both slight and severe postoperative pain.
非甾体抗炎药（NSAIDs）常用于治疗炎症、疼痛和发热，但脊柱手术后的术后疼痛管理尚无标准规范。在本研究中，我们比较了洛索洛芬钠（洛索洛芬）和塞来昔布对脊柱手术后疼痛管理的镇痛效果。
141例患者（平均年龄62.2岁）在脊柱手术前被随机分为两组：洛索洛芬组（n = 73，180 mg/天）和塞来昔布组（n = 68，200 mg/天）。药物从术后第1天开始服用，持续至术后第7天。使用数字评分量表（NRS）在每天九个预先设定的时间评估疼痛，并比较两组的结果。还记录了实验室数据和不良事件。
洛索洛芬和塞来昔布在每天的最大和平均NRS评分上没有显著差异，表明这两种NSAIDs的镇痛效果相当。洛索洛芬在给药前（基线）至给药后30分钟或2小时的NRS评分改善更大。对于轻度疼痛（基线NRS评分<5）和重度疼痛（基线NRS评分≥5）均呈现这种趋势。一名患者因肾功能不全在第4天停用洛索洛芬。一名患者因个人要求在第2天停用塞来昔布。
洛索洛芬钠和塞来昔布对脊柱手术后急性疼痛的缓解均耐受性良好。对于轻度和重度术后疼痛，单次服用洛索洛芬与塞来昔布相比显示出更好和更快的效果。
