Effectiveness of celecoxib for pain relief and antipyresis in second trimester medical abortions with misoprostol: a randomized controlled trial.

Abstract

To evaluate the effectiveness of celecoxib for pain relief and antipyresis during second trimester abortion using sublingual misoprostol. Fifty-six pregnant women of gestational age 14-24weeks were randomly assigned in a double-blind randomized controlled trial to receive 400mg of celecoxib or placebo just before sublingual administration of misoprostol 400µg every 6h. Pain and body temperature (BT) were assessed every 1h until the abortion or 24h after the first dose of misoprostol. Pain was assessed using a 10-cm Visual Analog Scale (VAS). BT was measured with an infrared thermometer. From January 2016 through September 2016, 28 patients were randomized into each study group. The mean VAS pain score at the completion of the abortion in the celecoxib group was significantly lower than in the placebo group (4.6±2.8 vs. 7.3±2.2) (p=0.012). But 42.9% of patients in both groups experienced severe pain and needed equivalent amounts of morphine rescue. The overall mean BT in the celecoxib group was significantly lower than in the placebo group [-0.09 (SD=0.04)] (p=0.017). The mean BTs at 1, 2 and 6h after each repeated dose of misoprostol in the celecoxib group were also significantly lower than in the placebo group. Single-dose 400mg celecoxib had an inadequate beneficial effect on pain relief but significant antipyretic effect during second trimester abortions using sublingual misoprostol.