The Impact of Parecoxib on Pain Management for Laparoscopic Cholecystectomy: A Meta-analysis of Randomized Controlled Trials

Introduction: The efficacy of parecoxib on pain management for laparoscopic cholecystectomy remains controversial. We conducted a systematic review and meta-analysis to explore the impact of parecoxib on pain management after laparoscopic cholecystectomy. Materials and Methods: We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library database results through September 2018 for randomized controlled trials to assess the effect of IV parecoxib versus placebo or noting on pain management after laparoscopic cholecystectomy. This meta-analysis was performed using the random-effect model. Results: Seven randomized controlled trials were included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, intravenous parecoxib showed no notable impact on pain scores within 2 hours [mean difference (MD), -0.22; 95% confidence interval (CI), -0.82 to 0.38; P=0.48] and 4 hours (MD, -0.33; 95% CI, -1.04 to 0.38; P=0.36), but showed results of significant decrease in pain scores at 6 hours (MD, -0.82; 95% CI, -1.45 to -0.20; P=0.01), 12 hours (MD, -0.69; 95% CI, -1.23 to -0.15; P=0.01), 24 hours (MD, -0.49; 95% CI, -0.89 to -0.10; P=0.01), and postoperative analgesics need (risk ratio, 0.45; 95% CI, 0.30-0.65; P<0.0001). In addition, no increase in nausea and vomiting is observed after parecoxib use compared with control intervention (risk ratio, 0.89; 95% CI, 0.44-0.76; P=0.76). Conclusions: Parecoxib can substantially promote postoperative pain relief in patients with laparoscopic cholecystectomy.