Evaluation of preoperative administration of the cyclooxygenase-2 inhibitor rofecoxib for the treatment of postoperative pain after lumbar disc surgery

Alex Bekker, Paul R. Cooper, Anthony Frempong-Boadu, Ramesh Babu, Thomas Errico, Allen Lebovits, Kim Burchiel, Volker K H Sonntag, Edward C. Benzel, Donlin M. Long

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

OBJECTIVE: A combination of analgesics with different mechanisms of action may improve postoperative pain control and reduce the incidence of side effects. This study was designed to assess the efficacy of preoperative administration of rofecoxib (Vioxx; Merck & Co., Inc., Somerset, NJ) in reducing pain and opioid requirements after single-level lumbar microdiscectomy. METHODS: A randomized, double-blind, placebo-controlled clinical trial was performed on 61 consenting patients who were considered American Society of Anesthesiologists Class I or II and who were scheduled for elective single-level lumbar microdiscectomy. Patients received either two doses of rofecoxib 50 mg or a placebo preoperatively. The outcome measures included morphine use in the postanesthesia care unit (PACU), discharge times, and side effect profile. Data were analyzed by use of independent sample t tests for continuous variables or X2 tests for categorical variables. A P value of <0.05 was considered significant. RESULTS: The two groups were comparable with respect to patient characteristics, intraoperative opioid and hypnotic consumption, and duration of surgery. Patients in the rofecoxib group required significantly less morphine postoperatively. Significantly more patients in the placebo group reported pain scores greater than 7 at admission to the PACU. Time to first request for analgesia was shorter in the placebo group, but the difference did not reach statistical significance. There were no significant differences between groups in the incidence of nausea, time to discharge from the PACU, or hospital stay. CONCLUSION: Preoperative rofecoxib is effective in reducing postoperative narcotic consumption in patients undergoing lumbar laminectomy. The use of rofecoxib does not shorten PACU length of stay or hospital discharge time. These outcome measures depend on multiple administrative factors.

Original languageEnglish (US)
Pages (from-to)1053-1058
Number of pages6
JournalNeurosurgery
Volume50
Issue number5
DOIs
StatePublished - May 1 2002
Externally publishedYes

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Cyclooxygenase 2 Inhibitors
Postoperative Pain
Placebos
Morphine
Opioid Analgesics
Length of Stay
Therapeutics
Outcome Assessment (Health Care)
Pain
Laminectomy
Narcotics
Incidence
Controlled Clinical Trials
Hypnotics and Sedatives
Analgesia
Nausea
Analgesics
rofecoxib

Keywords

  • Analgesia
  • Lumbar discectomy
  • Postoperative
  • Rofecoxib

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Evaluation of preoperative administration of the cyclooxygenase-2 inhibitor rofecoxib for the treatment of postoperative pain after lumbar disc surgery. / Bekker, Alex; Cooper, Paul R.; Frempong-Boadu, Anthony; Babu, Ramesh; Errico, Thomas; Lebovits, Allen; Burchiel, Kim; Sonntag, Volker K H; Benzel, Edward C.; Long, Donlin M.

In: Neurosurgery, Vol. 50, No. 5, 01.05.2002, p. 1053-1058.

Research output: Contribution to journalArticle

Bekker, A, Cooper, PR, Frempong-Boadu, A, Babu, R, Errico, T, Lebovits, A, Burchiel, K, Sonntag, VKH, Benzel, EC & Long, DM 2002, 'Evaluation of preoperative administration of the cyclooxygenase-2 inhibitor rofecoxib for the treatment of postoperative pain after lumbar disc surgery', Neurosurgery, vol. 50, no. 5, pp. 1053-1058. https://doi.org/10.1097/00006123-200205000-00019
Bekker, Alex ; Cooper, Paul R. ; Frempong-Boadu, Anthony ; Babu, Ramesh ; Errico, Thomas ; Lebovits, Allen ; Burchiel, Kim ; Sonntag, Volker K H ; Benzel, Edward C. ; Long, Donlin M. / Evaluation of preoperative administration of the cyclooxygenase-2 inhibitor rofecoxib for the treatment of postoperative pain after lumbar disc surgery. In: Neurosurgery. 2002 ; Vol. 50, No. 5. pp. 1053-1058.
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T1 - Evaluation of preoperative administration of the cyclooxygenase-2 inhibitor rofecoxib for the treatment of postoperative pain after lumbar disc surgery

AU - Bekker, Alex

AU - Cooper, Paul R.

AU - Frempong-Boadu, Anthony

AU - Babu, Ramesh

AU - Errico, Thomas

AU - Lebovits, Allen

AU - Burchiel, Kim

AU - Sonntag, Volker K H

AU - Benzel, Edward C.

AU - Long, Donlin M.

PY - 2002/5/1

Y1 - 2002/5/1

N2 - OBJECTIVE: A combination of analgesics with different mechanisms of action may improve postoperative pain control and reduce the incidence of side effects. This study was designed to assess the efficacy of preoperative administration of rofecoxib (Vioxx; Merck & Co., Inc., Somerset, NJ) in reducing pain and opioid requirements after single-level lumbar microdiscectomy. METHODS: A randomized, double-blind, placebo-controlled clinical trial was performed on 61 consenting patients who were considered American Society of Anesthesiologists Class I or II and who were scheduled for elective single-level lumbar microdiscectomy. Patients received either two doses of rofecoxib 50 mg or a placebo preoperatively. The outcome measures included morphine use in the postanesthesia care unit (PACU), discharge times, and side effect profile. Data were analyzed by use of independent sample t tests for continuous variables or X2 tests for categorical variables. A P value of <0.05 was considered significant. RESULTS: The two groups were comparable with respect to patient characteristics, intraoperative opioid and hypnotic consumption, and duration of surgery. Patients in the rofecoxib group required significantly less morphine postoperatively. Significantly more patients in the placebo group reported pain scores greater than 7 at admission to the PACU. Time to first request for analgesia was shorter in the placebo group, but the difference did not reach statistical significance. There were no significant differences between groups in the incidence of nausea, time to discharge from the PACU, or hospital stay. CONCLUSION: Preoperative rofecoxib is effective in reducing postoperative narcotic consumption in patients undergoing lumbar laminectomy. The use of rofecoxib does not shorten PACU length of stay or hospital discharge time. These outcome measures depend on multiple administrative factors.

AB - OBJECTIVE: A combination of analgesics with different mechanisms of action may improve postoperative pain control and reduce the incidence of side effects. This study was designed to assess the efficacy of preoperative administration of rofecoxib (Vioxx; Merck & Co., Inc., Somerset, NJ) in reducing pain and opioid requirements after single-level lumbar microdiscectomy. METHODS: A randomized, double-blind, placebo-controlled clinical trial was performed on 61 consenting patients who were considered American Society of Anesthesiologists Class I or II and who were scheduled for elective single-level lumbar microdiscectomy. Patients received either two doses of rofecoxib 50 mg or a placebo preoperatively. The outcome measures included morphine use in the postanesthesia care unit (PACU), discharge times, and side effect profile. Data were analyzed by use of independent sample t tests for continuous variables or X2 tests for categorical variables. A P value of <0.05 was considered significant. RESULTS: The two groups were comparable with respect to patient characteristics, intraoperative opioid and hypnotic consumption, and duration of surgery. Patients in the rofecoxib group required significantly less morphine postoperatively. Significantly more patients in the placebo group reported pain scores greater than 7 at admission to the PACU. Time to first request for analgesia was shorter in the placebo group, but the difference did not reach statistical significance. There were no significant differences between groups in the incidence of nausea, time to discharge from the PACU, or hospital stay. CONCLUSION: Preoperative rofecoxib is effective in reducing postoperative narcotic consumption in patients undergoing lumbar laminectomy. The use of rofecoxib does not shorten PACU length of stay or hospital discharge time. These outcome measures depend on multiple administrative factors.

KW - Analgesia

KW - Lumbar discectomy

KW - Postoperative

KW - Rofecoxib

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