Efficacy of parecoxib for reducing pyelovenous backflow pain during retrograde intrarenal surgery

Abstract

ObjectiveThe goal of this paper is to evaluate the safety and efficacy of perioperative Parecoxib, a COX-2 inhibitor in reducing transient postoperative pyelovenous backflow pain in patients undergoing retrograde intrarenal surgery (RIRS). Materials and methodsWe instituted a change in our institutional clinical practice starting in Jan 2016. Since January 2016, all patients undergoing RIRS were administered perioperative intravenous Parecoxib. Patients with a history of chronic renal failure (Cr over 2.5) or coronary heart disease did not receive Parecoxib. The Numerical Scale (NRS) was recorded after postoperative conscious recovery within 24 h of the postoperative hospitalization. The NRS values were compared with a matched cohort of patients treated with RIRS at our center prior to the January 2016 initiation of Parecoxib administration to RIRS patients. ResultsA total of 116 patients received Parecoxib during RIRS between Jan 2016 and August 2016. We found that Parecoxib infusion was associated with significantly decreased of NRS. 116 of 243 patients treated with Parecoxib received a NRS of 1.57 points versus 127 of 243 matched controls who had a NRS of 3.32 points (p < .0001). The proportion of NRS > 4 score in the patients with Parecoxib infusion is much lower than those patients who did not receive Parecoxib (9% vs. 30%). ConclusionUse of perioperative Parecoxib during RIRS is associated with a significant reduction in transient postoperative pyelovenous backflow pain and increased operation quality.