การใช้ยา Parecoxib สำหรับระงับปวดเฉียบพลันในห้องฉุกเฉิน: การทบทวนวรรณกรรม

Thampron Thongphan

Authors

Thampron Thongphan Department of Emergency Medicine, Bangkok Hospital Headquarters

Keywords:

parecoxib, acute pain, emergency department, multimodal analgesia, COX-2

Abstract

Parecoxib is an injectable COX-2 selective nonsteroidal anti-inflammatory drug with properties that make it suitable for use in the emergency department (ED). This narrative review aims to summarize the current evidence on the pharmacology, efficacy, and safety of parecoxib, as well as its role in multimodal analgesia for ED patients. Available data suggest that parecoxib provides analgesia comparable to nonselective NSAIDs without clear impairment of platelet function and may be associated with a lower risk of gastrointestinal adverse events. These characteristics indicate that parecoxib could be a useful non-opioid component of multimodal pain management in the ED. Nevertheless, its use should be individualized, avoiding administration in patients with hypersensitivity to parecoxib, celecoxib, or severe sulfonamide allergy, using caution in patients with pre-existing cardiovascular disease, and avoiding use in those with severe renal impairment. However, ED-specific studies remain limited, and further well-designed clinical trials are needed to better define the role of parecoxib in the management of acute pain in the ED.

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