Perioperative celecoxib use during hysterectomy may reduce the need for oral narcotics after hospital discharge, according to a study presented at the 2017 Society of Gynecologic Oncology Annual Meeting. The study evaluated the effect of perioperative celecoxib or ketorolac use on postoperative pain control after hysterectomy.1
In the study, 138 women undergoing robotic hysterectomy were randomly assigned to receive celecoxib (400 mg orally) prior to surgery or ketorolac (15 mg intravenous every 6 hours) during surgery. Patients in the celecoxib arm also received celecoxib (200 mg orally twice daily) for 7 days postoperatively. All patients received preoperative and postoperative paracetamol (975 mg orally every 8 hours) and gabapentin (100 mg orally every 8 hours).
The visual analog scale (VAS) every 2 hours and use of postoperative narcotics were used to evaluate pain scores for the first day or until discharge. Outpatient narcotic use and return to activities of daily living (ADLs) were assessed by patient-reported questionnaire at 2 weeks follow-up.
There was no significant difference in VAS or postoperative narcotic use among patients treated with perioperative celecoxib or ketorolac. Outpatient use of narcotics, however, was significantly lower among women who received celecoxib compared with ketorolac with fewer oral narcotics needed after discharge (6.0 vs 8.1; P =.001) and earlier discontinuation of oral narcotics (3.8 vs 5.7 days; P <.001).
There was no difference in perioperative complication rates or days to return to ADLs.
According to the authors, results of this study suggest that “utilization of celecoxib for postoperative pain control may allow for reduced narcotic doses and reduce narcotic-prescribing practices in this patient population.”
1. Ulm M, Watson CH, Einagger AC, et al. A randomized controlled trial comparing the efficacy of perioperative celecoxib versus ketorolac for perioperative pain control. Presented at: 48th Annual Meeting of the Society of Gynecologic Oncology; March 12-15, 2017; National Harbor, MD.