Perioperative Pain Control With Celecoxib (Celebrex) in Total Knee Arthroplasty
Information source: National Taiwan University Hospital
Information obtained from ClinicalTrials.gov on October 19, 2009
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Osteoarthritis
Intervention: Celecoxib (Celebrex) (Drug)
Phase: Phase 4
Status: Recruiting
Sponsored by: National Taiwan University Hospital Official(s) and/or principal investigator(s):
Ching-Chuan Jiang, M.D.;Ph.D., Principal Investigator, Affiliation: National Taiwan University Hospital
Overall contact:
Ching-Chung Jiang, M.D.;Ph.D., Phone: 886-2-23123456, Ext: 5273, Email: ccj@ntu.edu.tw
Summary
We propose that administration perioperative celecoxib is effective to control postoperative
VAS pain scores, improve rehabilitation results, and decrease narcotics usage in total knee
replacement patients.
Clinical Details
Official title: Perioperative Pain Control With Celecoxib (Celebrex) in Total Knee Arthroplasty
Study design: Treatment, Randomized, Single Blind (Outcomes Assessor), Active Control, Parallel Assignment, Safety/Efficacy Study
Primary outcome: VAS pain scores, range-of-motion, narcotics usage
Detailed description:
Total knee replacement is an effective method to treat end-stage osteoarthritis. However,
post-operative pain is still a bothering problem. Pre-emptive analgesia is defined as an
antinociceptive treatment which prevents pain before its onset. Preoperative analgesia is
thought more effective than an equal post-operative dose. Surgical trauma induces the
synthesis of prostaglandins, which sensitize the peripheral nociceptors. Non-steroidal
anti-inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis both in the periphery and
the spinal cord, therefore decreasing the post-operative hyperalgesic state.
Celebrex (Celecoxib) is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat
arthritis, pain, menstrual cramps, and colonic polyps. Prostaglandins are chemicals that are
important contributors to the inflammation of arthritis that causes the pain, fever,
swelling and tenderness. Celecoxib blocks the enzyme that makes prostaglandins
(cyclooxygenase 2), resulting in lower concentrations of prostaglandins. As a consequence,
inflammation and its accompanying pain, fever, swelling and tenderness are reduced.
Celecoxib differs from other NSAIDs in that it causes less inflammation and ulceration of
the stomach and intestine (at least with short-term treatment) and does not interfere with
the clotting of blood.
The study group received 400mg oral celecoxib about 1 hr prior to total knee replacement
surgery, and 200mg every 12 hrs, along with PCA morphine, over the first five post-operative
days. The control group received PCA morphine over the same postoperative period. All
patients had spinal anesthesia and hemovac drain tubes inserted for postoperative blood loss
evaluation.
Specific aims and goals:
1. to establish better rehabilitation results and lower VAS pain scores after
administration perioperative celecoxib in total knee replacement patients.
2. to establish morphine sparing effect after perioperative celecoxib administration.
3. to evaluate the risks after prescribing perioperative celecoxib.
Eligibility
Minimum age: 60 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Patients receiving total knee replacement will be recruited in this study.
Exclusion Criteria:
- subjects with end-stage renal disease, cerebral vascular accident, peptic ulcer,
long-term usage of NSAIDs.
Locations and Contacts
Ching-Chung Jiang, M.D.;Ph.D., Phone: 886-2-23123456, Ext: 5273, Email: ccj@ntu.edu.tw
Ching-Chuan Jiang, Taipei city, Taiwan; Recruiting
Ching-Chuan Jiang, M.D.;Ph.D., Phone: 886-2-23123456, Ext: 5273, Email: ccj@ntu.edu.tw
Ching-Chuan Jiang, M.D.;Ph.D., Principal Investigator
Additional Information
Starting date: September 2006
Ending date: September 2008
Last updated: January 10, 2008
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