Preoperative analgesia management with rofecoxib in thoracotomy patients

Objective: Pain management after thoracotomy is significant because pain reduces the postoperative respiratory performance. In this study, the analgesic efficacy and safety of rofecoxib in thoracotomy patients were evaluated. Design: A prospective, randomized, double-blind, and placebo-controlled study. Setting: This study was performed in the Meram Medical School of Selcuk University Departments of Cardiovascular Surgery and Anesthesiology. Participants: Sixty patients undergoing elective thoracic surgery via thoracotomy were randomized to receive either oral placebo or rofecoxib, 50 mg, 1 hour before surgery. Interventions: All patients received a standard anesthetic. Pain scores, sedation scores, heart rate, mean arterial pressure, respiratory rate, analgesic requirements, and side effects were noted 2, 4, 8,12, 18, 24, 32, 40, and 48 hours after operation. Measurements and Main Results:There were no significant differences between the 2 study groups with respect to demographics, sedation score, intraoperative blood loss, and postoperative drainage. Compared with placebo, morphine consumption and pain scores at rest and during coughing were significantly lower with rofecoxib. Conclusions: The preoperative administration of rofecoxib, 50 mg, provides significant analgesia for postoperative pain relief and decreases additional opioid requirements after thoracotomy. (C) 2005 Elsevier Inc. All rights reserved.