The application of pre-emptive parecoxib alleviated postoperative pain after percutaneous endoscopic lumbar discectomy

Purpose: The purpose of this study was to determine the clinical efficacy of pre-emptive parecoxib in the percutaneous endoscopic lumbar discectomy. Methods: Eighty patients were randomly allocated to receive either parecoxib or sodium chloride brine as placebo 30 minutes prior to the percutaneous endoscopic lumbar discectomy. Clinical data was obtained and recorded at 1, 6, 12, 24 hours after operation, including surgery time, intraoperatve blood loss and hospitalization duration. The functional outcomes were evaluated by postoperative complications, visual analogue scale (VAS) of leg pain, oswestry disability index (ODI) and modified Macnab criteria. Time to achieved straight leg raises, time to 1st rescue analgesia, Sum of analgesics consumed during the first 5 days was noted. Incidences of adverse events were recorded. Results: The patients' characteristics and operative data were similar between the groups. The VAS score of leg pain and ODI score were lower in the parecoxib group than in the placebo group; the differences were confirmed as significant at 1, 6 and 12 hours after operation while not significant at 24 hours. The patients in the parecoxib group achieved straight leg raises earlier than those in the placebo group. Patients in the parecoxib group reported a longer pain free interval and consumed less sum of rescue analgesics during the first 5 days than those in the placebo group, the difference was statistically significant. With respect to modified Macnab's criteria, more patients exerted excellent and good clinical outcomes in parecoxib group than those of placebo group. Conclusions: The application of pre-emptive parecoxib significantly alleviated early postoperative pain decreased the sum of rescue analgesics and improved patient satisfaction after percutaneous endoscopic lumbar discectomy. Therefore, pre-emptive parecoxib may be useful in pain relief of the percutaneous endoscopic lumbar discectomy.