Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
Department of Orthopedics, Beijing Jishuitan Hospital, Beijing, China.
Pain Physician. 2018 Sep;21(5):483-488.
Total hip arthroplasty (THA) is a well-accepted surgical treatment for terminal hip diseases.
To evaluate the effect of preemptive analgesia with parecoxib in patients undergoing primary unilateral THA.
A randomized, double-blind, placebo-controlled study.
This study was conducted at Peking Union Medical College Hospital and Beijing Jishuitan Hospital in Beijing, China.
A total of 94 patients scheduled for primary unilateral THA in 2 centers (Peking Union Medical College Hospital and Beijing Jishuitan Hospital) were randomly assigned to receive 40 mg parecoxib (n = 48) or 0.9% normal saline solution (n = 46) 30 minutes before incision. All patients received standardized intravenous patient-controlled analgesia (PCA) postoperatively. Preoperative baseline data, surgery-related conditions, postoperative Visual Analog Scale (VAS) pain score, cumulative narcotic consumption of PCA, and complications were compared between the parecoxib group and the placebo group.
There were no significant differences in postoperative VAS pain score, cumulative narcotic consumption of PCA, proportion of analgesic remedy, and complications between the 2 groups.
Only a single dose of parecoxib was used without including a dose-dependent control group.
A single dose of parecoxib 30 minutes before incision did not provide effective preemptive analgesia for the management of postoperative pain after primary unilateral THA. The possible effect of preemptive analgesia with parecoxib needs further investigation.
Total hip arthroplasty, pain, parecoxib, COX-2 selective inhibitor, preemptive analgesia, clinical trial, patient-controlled analgesia, analgesics.
全髋关节置换术（THA）是治疗晚期髋关节疾病的一种广泛接受的手术治疗方法。
评估在初次单侧 THA 患者中使用帕瑞昔布进行预防性镇痛的效果。
随机、双盲、安慰剂对照研究。
本研究在北京的中国医学科学院北京协和医院和北京积水潭医院进行。
共有 94 例在 2 家中心（中国医学科学院北京协和医院和北京积水潭医院）计划接受初次单侧 THA 的患者被随机分配接受 40mg 帕瑞昔布（n=48）或 0.9%生理盐水（n=46），在切开前 30 分钟给予。所有患者术后均接受标准化静脉患者自控镇痛（PCA）。比较帕瑞昔布组和安慰剂组之间的术前基线数据、手术相关情况、术后视觉模拟评分（VAS）疼痛评分、PCA 累积阿片类药物消耗以及并发症。
两组患者术后 VAS 疼痛评分、PCA 累积阿片类药物消耗、镇痛药补救比例和并发症发生率均无显著差异。
仅使用了单次剂量的帕瑞昔布，没有包括剂量依赖性对照组。
在初次单侧 THA 术后疼痛管理中，切开前 30 分钟给予单次剂量的帕瑞昔布并不能提供有效的预防性镇痛。需要进一步研究帕瑞昔布预防性镇痛的可能效果。
全髋关节置换术；疼痛；帕瑞昔布；COX-2 选择性抑制剂；预防性镇痛；临床试验；患者自控镇痛；镇痛药。
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