Anest. intenziv. Med. 2011;22(3):137-145

Premedication with etoricoxib before tonsillectomyAnaesthesiology - Original Paper

Leštianský Boris^1,*, Hakl Marek¹, Pešlová Marie¹, Veselá Vladimíra², Pavlík Tomáš³, Kostřica Roman²

¹ Anesteziologicko-resuscitační klinika LF MU a FN u sv. Anny v Brně

² Klinika otorinolaryngologie, chirurgie hlavy a krku LF MU a FN u sv. Anny v Brně

³ Institut biostatistiky a analýz Masarykovy univerzity v Brně

Objective:
The goal of the study was to determine the analgesic effect of etoricoxib administered before tonsillectomy.

Design:
Interdisciplinary, prospective, randomised clinical trial.


Setting:
ICU, University Hospital.

Materials and methods:
The study included adult ASA I and II patients undergoing simple tonsillectomy. The exclusion criteria included a general contraindication to cyclooxygenase-2 (COX-2) inhibitors. The surgical procedure was performed under general anaesthesia with orotracheal intubation. Total 75 patients were randomised into two groups, etoricoxib (n = 38) and control (n = 37). The primary outcome was post-tonsillectomy pain using VAS. We analysed the postoperative analgesic consumption (metamizol vs. piritramid) during the first 24 hours after tonsillectomy. We also evaluated the quality of postoperative pain control and the relative incidence in the two groups. The secondary outcomes included the incidence of post-tonsillectomy bleeding and the need for surgical reoperation for haemostasis.

Results:
The results showed a statistically significant reduction in the analgesic consumption after 3 (p = 0.004) and 24 hours (p = 0.019) in the etoricoxib group. There were significant differences between the groups in the quality of pain control in the etoricoxib vs. control group (pain at rest 15.8 % vs. 51.4 %, p = 0.001) as well as the type of the pain (sharp pain 50 % vs. blunt pain 81.1 %, p = 0.007). Analysis of VAS showed a stable intensity of pain during the first 24 hours in the etoricoxib group.

Conclusion:
We observed a lower overall consumption of non-opioid postoperative analgesia (p = 0.001), better quality of pain control and relatively stable intensity of pain in the etoricoxib group.

Keywords: premedication with etoricoxib; tonsillectomy; cyclooxygenase-2 inhibitors

Received: October 18, 2010; Accepted: April 1, 2011; Published: June 1, 2011  Show citation