Preemptive Analgesic Efficacy of Parecoxib vs Placebo in Infertile Women Undergoing Diagnostic Laparoscopy: Randomized Controlled Trial

Study Objective: To compare the preemptive analgesic efficacy between parecoxib and placebo in infertile women undergoing outpatient diagnostic laparoscopy. Design: Double-blind, randomized, placebo-controlled study (Canadian Task Force classification I). Setting: Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Patients: Sixty infertile women undergoing diagnostic laparoscopy from November 2009 to January 2011. Intervention: Patients were randomized to receive either 40 mg parecoxib (treatment group) or normal saline solution as placebo (control group) intravenously at 15 minutes before surgery. Postoperative shoulder and wound pain was self-assessed using a visual analog scale at 2, 6, 12, and 24 hours after surgery. Administration of rescue analgesic agents, and adverse effects were recorded. Measurements and Main Results: There were 30 patients in each group. Shoulder pain scores at each time measured, as well as wound pain score, was significantly lower in the parecoxib group compared with the placebo group (p < .001). The percentage of patients who required postoperative rescue analgesic therapy was lower in the treatment group compared with the control group (26.7% and 40.0%, respectively; p = .04). The treatment group required less rescue analgesic therapy than did the control group (mean [SD], 314.8 [53.9] and 842.6 [122.7] mg acetaminophen; p = .04). There was no significant difference in adverse effects between the 2 groups. Conclusion: Preoperative administration of 40 mg parecoxib, compared with placebo, provided significantly superior postoperative pain relief after diagnostic laparoscopy. Journal of Minimally Invasive Gynecology (2012) 19, 585-588 (c) 2012 AAGL. All rights reserved.