A Randomized Controlled Trial Comparing Preoperative Celecoxib vs Etoricoxib Combined with Paracetamol for Postoperative Pain Management after Total Abdominal Hysterectomy
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Abstract
Background: Preemptive multimodal analgesia, particularly using COX-2 inhibitors combined with paracetamol, may effectively reduce postoperative pain and morphine consumption following abdominal hysterectomy. The study aims to compare the efficacy of preoperative celecoxib or etoricoxib combined with paracetamol in reducing postoperative pain and morphine use. Methods: A randomized controlled trial was conducted in 63 patients undergoing abdominal hysterectomy. Participants were randomized into three groups: celecoxib 400 mg and paracetamol 500 mg, etoricoxib 90 mg and paracetamol 500 mg and a control group receiving no preoperative medication. Pain scores were assessed using the numerical rating scale (NRS) at 1, 4, 8, and 24 h, postoperatively. Morphine consumption within 24 h was recorded. Statistical analysis included ANOVA, Kruskal-Wallis, and Chi-square tests. Results: Morphine consumption within 24 h differed significantly among groups (P=0.016), with the etoricoxib group using the least (3.4 ± 2.9 mg) significantly lower than the control group (P=0.012). The celecoxib group did not differ significantly from the control (P=0.220). Pain scores were not significantly different among the groups. Conclusion: Preoperative etoricoxib combined with paracetamol significantly reduces postoperative morphine use and is suitable as part of a multimodal analgesia strategy.
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