A randomized controlled trial of preprocedure administration of parecoxib for therapeutic endoscopic retrograde cholangiopancreatography Full Text
Journal of Pain Research, 08/17/2012
Amornyotin S et al. – Preprocedure administration of parecoxib for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) patients was clinically effective. The analgesic efficacy of a standard dose of parecoxib was clearly demonstrated during the first 12 hours postprocedure. Additionally, patient satisfaction in the parecoxib group was also higher than in the control group.Methods
- Eighty–five patients who underwent therapeutic ERCP in a single year were randomly assigned to normal saline group (C, n = 43) and parecoxib group (P, n = 42).
- Patients in group C received normal saline and those in group P received 40 mg of parecoxib intravenously in equivalent volume.
- Patients in both groups received the saline or parecoxib 60 seconds before administration of the sedative agents.
- All patients were monitored for the depth of sedation by using the NarcotrendTM monitor, maintaining stage D0–E0 during ERCP.
- All patients were oxygenated with 100% O2 via nasal cannula and sedated with 0.03 mg/kg of intravenous midazolam and 1 µg/kg of intravenous fentanyl as well as the titration of intravenous propofol.
- After the ERCP procedure, pethidine in an intramuscular dose of 0.5–1.0 mg/kg was used as rescue medication.
- The pain scores (visual analog scale [VAS], 0–10) at 2, 12, and 24 hours post–ERCP, the total number of doses of pethidine used, the dose volume of pethidine used, patient satisfaction, endoscopist satisfaction, and complications were recorded.
- There were no significant differences in sedative and analgesic agents used during the procedure, pain at 24 hours post–ERCP, endoscopist satisfaction, and complications in both groups.
- The total number of doses of pethidine used post–ERCP in group C was significantly higher than in group P.
- Additionally, the mean pain score at 2 and 12 hours post–ERCP in group C was significantly greater than in group P.
- Patient satisfaction in group P was higher than in group C.