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Combination of Parecoxib plus Nefopam can be used
for pain relief after gynecological surgery
As compared to parecoxib alone, the intravenous
(IV) administration of combination of nefopam and parecoxib during open
abdominal gynecological surgery is effective in reducing pain at 6 and
12 hours after the surgery, suggested a randomised controlled study in
Anesthesiology Research and Practice.
This study outcome was based on 71 patients
(aged 20 to 65 years) divided into either the use of parecoxib 40 mg plus nefopam
20 mg IV (Study group) or parecoxib 40 mg plus normal saline solution (Control
group) during gynecologic surgery. Nefopam or normal saline was given in both
the groups every 6 hours for 24 hours after the surgery. Morphine was used as IV
patient-controlled analgesia for flare-up within 24 hours. Use of morphine in 24 hours and postoperative pain via a numerical
rating scale (VNRS) was assessed at a postanesthetic care unit at 6, 12, and
24-hour.
Morphine usage within 24 hours and adverse effects were not considerably different between the groups. The VNRS on movement at 6 hours and 12 hours in the study group after surgery was significant different as compared to control group:
Figure 1: Pain scores at different time points
after the operation
Multimodal analgesia using nefopam and parecoxib
portrayed superior analgesic efficacy than parecoxib alone for postoperative
pain management.
Anesthesiology Research and Practice
Perioperative Intravenous Patient-Controlled Analgesic Efficacy of Morphine with Combined Nefopam and Parecoxib versus Parecoxib in Gynecologic Surgery: A Randomized, Double-Blind Study
Varinee Lekprasert et al.
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