The efficacy of pre-emptive etoricoxib for laparoscopic cholecystectomy: a systematic review and meta-analysis

Background: Pre-emptive etoricoxib may be beneficial for pain control in laparoscopic cholecystectomy patients. However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the efficacy of etoricoxib after laparoscopic cholecystectomy. Methods: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of etoricoxib on pain intensity after laparoscopic cholecystectomy were included. Two investigators independently searched articles, extracted data, and assessed the quality of the included studies. This meta-analysis is performed using the random-effect model. Results: Four RCTs are included in the meta-analysis. Overall, compared with control intervention following laparoscopic cholecystectomy, etoricoxib intervention significantly reduce pain scores (Std. MD=-0.69; 95% CI=-1.02 to -0.37; P<0.0001) and the incidence of shoulder/flank pain (RR=0.65; 95% CI=0.50 to 0.85; P=0.002), but showed no notable impact on operation time (Std. MD=-0.18; 95% CI=-0.41 to 0.05; P=0.13), nausea and vomiting (RR=0.68; 95% CI=0.42 to 1.10; P=0.11), dizziness (RR=0.67; 95% CI=0.42 to 1.06; P=0.09), or headache (RR=0.96; 95% CI=0.44 to 2.09; P=0.92). Conclusions: Compared to control intervention after laparoscopic cholecystectomy, pre-emptive etoricoxib is found to significantly reduce the pain scores and the incidence of shoulder/flank pain, but has no substantial influence on nausea and vomiting, dizziness, and headache.