Effect of Parecoxib on Postoperative Pain Management After Total Knee/Hip Arthroplasty: A Systematic Review and Meta-Analysis

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Jan 11

PMID 36628043

Authors

Sri Nikhil Zallipalli

Rakesh Reddy Bethi

Madhuri Kandru

Nikith Kashyap Dendukuri

Geethanjali Gandla

Sree Sai Siddhardha Vemuri

Harish Peri

Saichand Linga

Affiliations

Soon will be listed here.

Abstract

Background: Total knee arthroplasty (TKA) or total hip arthroplasty (THA) are frequent procedures used to relieve the symptoms of hip or knee joint dysfunction, enhance disease recovery, and boost patients' quality of life. Nevertheless, postoperative pain has been a significant disadvantage since it strongly impacts patients' postoperative recovery. Parecoxib has been demonstrated to be useful in the management of postoperative pain in a variety of surgical procedures. While parecoxib can help with postoperative pain, its analgesic and unfavourable effects in TKA/THA patients have not been well studied.

Methods: A systematic search of peer-reviewed articles was conducted through the PubMed database, Google Scholar, and Cochrane library to retrieve related studies published in the English language that met inclusion and exclusion criteria. The publication date was restricted to the past 10 years (2012-2022). Results were analyzed using Review Manager software (RevMan version 5.4.1, The Cochrane Collaboration, 2020). The quality of the studies included was assessed using Jadad scores. Risk ratios (RR) standard mean difference (SMD) and 95% confidence intervals (CI) were calculated to analyze the primary and secondary endpoints.

Results: Eleven randomized controlled trials covering 1911 patients who underwent TKA/THA were selected. The pooled results indicated that the parecoxib group has lower visual analogue scale (VAS) scores than the placebo group. However, there was no significant difference in the secondary endpoint. The Jadad scores ranged from 3 to 5 and most of the studies were of high quality.

Conclusion: The results of our meta-analysis indicate that parecoxib has a better analgesic effect compared to placebo. It alleviates postoperative orthopaedic pain without raising the risk of adverse events.

References

Ma H, Chou T, Wang H, Tsai S, Chen C, Wu P . An opioid-sparing protocol with intravenous parecoxib can effectively reduce morphine consumption after simultaneous bilateral total knee arthroplasty. Sci Rep. 2021; 11(1):7362. PMC: 8016913. DOI: 10.1038/s41598-021-86826-7. View

Mu D, Zhang D, Wang D, Wang G, Li C, Meng Z . Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial. Anesth Analg. 2017; 124(6):1992-2000. DOI: 10.1213/ANE.0000000000002095. View

Camu F, Borgeat A, Heylen R, Viel E, Boye M, Cheung R . Parecoxib, propacetamol, and their combination for analgesia after total hip arthroplasty: a randomized non-inferiority trial. Acta Anaesthesiol Scand. 2016; 61(1):99-110. DOI: 10.1111/aas.12841. View

Wylde V, Beswick A, Bruce J, Blom A, Howells N, Gooberman-Hill R . Chronic pain after total knee arthroplasty. EFORT Open Rev. 2018; 3(8):461-470. PMC: 6134884. DOI: 10.1302/2058-5241.3.180004. View

Ng A, Smith G, Davidson A . Analgesic effects of parecoxib following total abdominal hysterectomy. Br J Anaesth. 2003; 90(6):746-9. DOI: 10.1093/bja/aeg139. View

Bian Y, Wang L, Qian W, Lin J, Jin J, Peng H . Role of Parecoxib Sodium in the Multimodal Analgesia after Total Knee Arthroplasty: A Randomized Double-blinded Controlled Trial. Orthop Surg. 2018; 10(4):321-327. PMC: 6594467. DOI: 10.1111/os.12410. View

Diaz-Borjon E, Torres-Gomez A, Noyes Essex M, Salomon P, Li C, Cheung R . Parecoxib Provides Analgesic and Opioid-Sparing Effects Following Major Orthopedic Surgery: A Subset Analysis of a Randomized, Placebo-Controlled Clinical Trial. Pain Ther. 2017; 6(1):61-72. PMC: 5447543. DOI: 10.1007/s40122-017-0066-5. View

Zhu Y, Wang S, Wu H, Wu Y . Effect of perioperative parecoxib on postoperative pain and local inflammation factors PGE2 and IL-6 for total knee arthroplasty: a randomized, double-blind, placebo-controlled study. Eur J Orthop Surg Traumatol. 2013; 24(3):395-401. DOI: 10.1007/s00590-013-1203-4. View

Camu F, Beecher T, Recker D, Verburg K . Valdecoxib, a COX-2-specific inhibitor, is an efficacious, opioid-sparing analgesic in patients undergoing hip arthroplasty. Am J Ther. 2002; 9(1):43-51. DOI: 10.1097/00045391-200201000-00009. View

10.

Xiao K, Yu L, Xiao W, Peng H, Bian Y, Wu Z . Pain Management Using Perioperative Administration of Parecoxib for Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. Pain Physician. 2019; 22(6):575-582. View

11.

Noyes Essex M, Choi H, Brown P, Cheung R . A randomized study of the efficacy and safety of parecoxib for the treatment of pain following total knee arthroplasty in Korean patients. J Pain Res. 2018; 11:427-433. PMC: 5827681. DOI: 10.2147/JPR.S147481. View

12.

Peng H, Wang L, Wang W, Tang Q, Qian W, Lin J . Preemptive Analgesia with Parecoxib in Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. Pain Physician. 2018; 21(5):483-488. View

13.

Zhu Y, Yao R, Zhang Z, Xu H, Wang L . Parecoxib prevents early postoperative cognitive dysfunction in elderly patients undergoing total knee arthroplasty: A double-blind, randomized clinical consort study. Medicine (Baltimore). 2016; 95(28):e4082. PMC: 4956786. DOI: 10.1097/MD.0000000000004082. View

14.

Wylde V, Rooker J, Halliday L, Blom A . Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep. Orthop Traumatol Surg Res. 2011; 97(2):139-44. DOI: 10.1016/j.otsr.2010.12.003. View

15.

Li X, Zhou P, Li Z, Tang H, Zhai S . Intravenous Parecoxib for Pain Relief after Orthopedic Surgery: A Systematic Review and Meta-analysis. Pain Ther. 2022; 11(3):771-787. PMC: 9314469. DOI: 10.1007/s40122-022-00400-1. View

16.

Schug S, Parsons B, Li C, Xia F . The safety profile of parecoxib for the treatment of postoperative pain: a pooled analysis of 28 randomized, double-blind, placebo-controlled clinical trials and a review of over 10 years of postauthorization data. J Pain Res. 2017; 10:2451-2459. PMC: 5644539. DOI: 10.2147/JPR.S136052. View

17.

Wei W, Zhao T, Li Y . Efficacy and safety of parecoxib sodium for acute postoperative pain: A meta-analysis. Exp Ther Med. 2013; 6(2):525-531. PMC: 3786997. DOI: 10.3892/etm.2013.1172. View

18.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021; 10(1):89. PMC: 8008539. DOI: 10.1186/s13643-021-01626-4. View

19.

Li J, Ma Y, Xiao L . Postoperative Pain Management in Total Knee Arthroplasty. Orthop Surg. 2019; 11(5):755-761. PMC: 6819170. DOI: 10.1111/os.12535. View

20.

Chuaychoosakoon C, Parinyakhup W, Wiwatboworn A, Purngpiputtrakul P, Wanasitchaiwat P, Boonriong T . Comparing the Efficacy of Postoperative Pain Control Between Intravenous Parecoxib and Oral Diclofenac in ACL Reconstruction. Orthop J Sports Med. 2021; 9(10):23259671211041660. PMC: 8532231. DOI: 10.1177/23259671211041660. View