Can Parecoxib Reduce Post-operative Ipsilateral Shoulder Pain?

Chiang Mai University160 enrolled

Overview

The purpose of this study is to compare the efficacy of parecoxib with placebo on the incidence and severity of postthoracotomy shoulder pain, the amount of analgesic requirement for relieving severity of postthoracotomy shoulder pain and adverse events associated with treatment.

The incidence of Post-operative Ipsilateral Shoulder Pain (PISP) varies from 21-97% after thoracic surgery, despite receiving effective thoracic epidural analgesia. This pain has been described as constant, aching in quality, unrelated to position change or respiration. Possible causes of shoulder pain includes injury of the phrenic nerve, the lateral decubitus position, transection of major bronchus or preexisting arthritis condition. The possibilities of prevention and management of PISP are taken into consideration. Thoracic epidural block will be performed in all patients before general anesthesia.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

160

Conditions

Shoulder Pain Post-operative Pain

Interventions

ParecoxibDRUG

Parecoxib 40 mg intravenous before surgery and every 12 hours for two days.

ControlOTHER

NSS 2 ml intravenous before surgery and every 12 hours for two days.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiology (ASA) physical status I-III * Undergoing pulmonary resection by open thoracotomy Exclusion Criteria: * Unable to understand numeric rating scale despite preoperative coaching * Preexisting shoulder pain at the same operative side * Having contraindication for thoracic epidural analgesia * History of previous myocardial ischemia or cerebrovascular accident * Allergic to NSAIDS, sulfonamides or parecoxib * Hepatic or renal impairment * History of current gastrointestinal symptoms * Fluid retention or congestive heart failure * Pregnancy

Locations (2)

Department of Anesthesiology, Faculty of Medicine, Chiang Mai University

Maung, Chiang Mai, Thailand

Department of Anesthesiology, Faculty of Medicine

Maung, Chiang Mai, Thailand

Outcomes

Primary Outcomes

Numeric rating scale (NRS) of shoulder pain and incisional pain at rest and movement

Time frame: at 2 ,6 ,12 ,24 ,48,72 and 96 hours after the operation

Secondary Outcomes

compare an amount of morphine consumption

Time frame: at 2,6 ,12,24,48,72 and 96 hours after the operation

adverse effect related to parecoxib

Time frame: during 96 hours

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.