Effects of premedication with celecoxib and pregabalin on postoperative pain in the elderly orthopedic patients
ZHANG Chang-feng, ZHENG Xian-he, HU Shuang-yan, CHEN Nian-ping, LI Yu-hong
2013, 18(9):
1039-1043.
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AIM: To observe the safety and effect on postoperative pain of premedication with celecoxib and pregabalin in the elderly orthopedic patients.METHODS: One hundred ASA ⅠorⅡelderly patients aged 68-84 year and weighing 52-64 kg undergoing elective operation on the femoral head or hip joint were randomly divided into 4 groups(n=30 each):control group(group C), celecoxib group(group S), pregabalin group(group P) and combination group(group L). Celecoxib 200 mg was taken in group S, pregabalin 300 mg was taken in group P, celecoxib 200 mg and pregabalin 150 mg were taken in group L before operation 1 h, while in group C placebo was taken. Patient-controlled intravenous analgesia with fentanyl and tramadol was used in all patients in 72 h after operation. If VAS score was more than 3, a bolus of fentanyl 0.2 μg/kg was given i.v.. And then the recovery time, moving VAS score and Ramsay score at 2,4,6,8,12,24 h postoperation, and total amount of fentanyl and tramadol in 72 h postoperation, and the incidence of adverse reaction included dizzy, lethargy, nausea and vomiting were recorded.RESULTS: Moving VAS score in group C at 2,4,6,8 h postoperation was higher than in other groups at the same time,while the score in group L at 8,12 h postoperation was lower.Ramsay score in group P at 2,4,6 h postoperation was higher than that in other groups at the same time,while the score in group L at 2,4 h postoperation was higher than that in group C and S. Compared with group P, the recovery time was shorter in group C, S and L.Compared with group C, the total amount of fentanyl and tramadol consumed in 72 h postoperation was smaller in group S, P and L. Compared with group L, the total amount of fentanyl and tramadol consumed was bigger in group S and P. Compared with group P, the incidence of adverse reaction was lower in group C, S and L (P<0.05).CONCLUSION: Celecoxib combined with pregabalin pretreatment can be used safely in elderly orthopedic patients, and can significantly reduce postoperative pain.