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[Postoperative analgesia after laparoscopic cholecystectomy: comparison of the preoperative administration of celecoxib with paracetamol?]

Author(s): Sami Mebazaa M, Frikha N, Ben Hammouda N, Mestiri T, Mestiri H, Khalfallah T, Ben Ammar MS

Affiliation(s): Service des Urlgences, CHU Mongi Slim La Marsa, CHU Mongi Slim La Marsa.

Publication date & source: 2008-10, Tunis Med., 86(10):869-73.

Publication type: Comparative Study; English Abstract; Randomized Controlled Trial

OBJECTIVE: The goal of this study was to evaluate the preventive analgesic effectiveness of paracetamol and celecoxib in laparoscopic cholecystectomy. METHODS: Randomized prospective study was undertaken, 75 patients of class ASA I and II were included, divided into three groups: P (Paracetamol 1000 mg), C (Celecoxib 200 mg) given orally one hour before induction and group T (without preoperative analgesia). The VAS at rest and effort was noted on arrival in the recovery room then with regular intervals (T(30mn) to T(h24). A morphine titration was carried out during the first 12 postoperative hours. Hemodynamic parameters, Ramsay score and the adverse effects were noted. RESULTS: The three groups were comparable for the demographic data, the duration of anesthesia and peroperative morphine consumption. The evolution of VAS scores shows a significant difference between the groups P and T with the effort of cough at t24h (p = 0.04), and between the groups C and T at postoperative T 4h (p = 0.016). In our study the group C consumed to a significant degree less morphine 5.44 +/- 3.00 Mg against 7.83 +/- 4.00 Mg for the group P (p < 0.03) and 8.04 +/- 3.00 Mg for the group T (p < 0.008). CONCLUSION: The administration of 200 Mg of celecoxib in the preoperative period of a laparoscopic cholecystectomy allows a significant decrease in morphine consumption in the postoperative period and a reduction in the scores of the VAS at rest and at the effort of cough compared to the groups which received only one placebo or paracetamol.

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