Analgesic effects of rofecoxib versus ibuprofen following major abdominal surgery

Simona Mărgărit, I. Acalovschi, Cipriana Chira, Rodica Găvruş
Catedra ATI.Universitatea de Medicină şi Farmacie„Iuliu Haţieganu” Cluj Napoca

Abstract

Introduction. Nonsteroidal antiinflamatory drugs are used for the multimodal management of postoperative pain and may have significant opioid-sparing effect after major surgery. This study was designed to determine if the administration of a preoperative dose of rofecoxib 50 mg or ibuprofen 400 mg to a patient who had undergone colon and gastric surgery, would enhance analgesia and decrease PCA morphine use.

Methods. After institutional approval and informed consent 45 patients ASAI/II were included in a double-blind, randomised study. Patients were scheduled for colon or gastric surgery. All patients received PCA morphine and were divided into three groups. Preoperatively they were given oral rofecoxib 50 mg, ibuprofen 400 mg, or a placebo. The outcome measure included: the total dose of morphine over 24 h, pain score at rest and on movement, the incidence of side-effects.

Results. The total dose of morphine was significantly increased in the placebo group in comparison with the other two groups (p<0.05). Analgesic consumption was similar in both rofecoxib and ibuprofen group. The pain scores were lower than in the placebo group but no significant differences were noted between rofecoxib and ibuprofen.

Conclusion. The use of rofecoxib and ibuprofen as a preoperative component of pain management with PCA morphine in major abdominal surgery decreased the morphine consumption. Administration of rofecoxib produced similar analgetic effects with ibuprofen.

Key words: rofecoxib, ibuprofen, morphine, patient-controlled analgesia

Rofecoxib versus ibuprofen asociate morfinei în regim PCA. Eficienţa analgetică în chirurgia abdominală majoră

Jurnalul Român de Anestezie Terapie intensivă 2004 Vol.11 Nr.1, 5-10