Effect of perioperative administration of parecoxib on post-tonsillectomy pain in adults

Post-tonsillectomy pain is one of the most difficult pain states to manage in otolaryngology. In this study, we investigated the analgesic effect of parecoxib in adults undergoing tonsillectomy. Eighty-eight patients that underwent tonsillectomy were randomly allocated to two groups to receive either intravenous 80 mg 24 h(-1) parecoxib (group P) or saline as control (group C) at two medical center of university. Anesthesia was induced using intravenous sufentanil and propofol, while endotracheal intubation was facilitated with rocuronium and maintenance was accomplished using sevoflurane. Pain scores, the rescue analgesic consumption, the frequency of postoperative complications including bleeding, nausea and vomiting and other major event were recorded 1, 2, 4, 12 and 24 h after the operation. P < 0.05 was considered statistically significant. In total, 80 patients successfully completed the study. Intravenous parecoxib (40 mg Bid), significantly reduced pain intensity both at rest and during swallowing in the first 24 h after tonsillectomy. The median pain score was reduced from moderate (4.5) to light pain (3) at rest and from severe pain (6.5) to moderated pain (4-5) during swallowing. Forty-four (43%) patients received paracetamol in the ward [22 (55%) in the control group and 12 (30%) in the parecoxib group; P < 0.05]. Re-operation for bleeding, postoperative nausea and vomiting (PONV) and other major adverse events were not different between groups. In conclusion, perioperative administration of parecoxib (40 mg, Bid) was effective for postoperative pain at rest relief in adults undergoing tonsillectomy.