Parecoxib vs. Dexketoprofeno, en combinación con paracetamol, como analgesia adicional en pacientes que reciben morfina neuraxial para el alivio del dolor postoperatorio en la cesárea: estudio prospectivo, aleatorizado, controlado, doble ciego

Abstract

ObjectiveTo evaluate the effectiveness of parecoxib vs. dexketoprofen, in combination with paracetamol, as additional analgesia in patients receiving neuraxial morphine for postoperative pain relief in cesarean section. MethodsA total of 380 patients scheduled for a cesarean section received neuraxial morphine for pain management. After the procedure, they were randomized to receive, as additional analgesia, 1g of paracetamol intravenously every 6h in combination with either 40mg of parecoxib intravenously every 12h or 50mg of dexketoprofen intravenously every 8h. A Visual Analog Scale (VAS) was used for evaluation of pain intensity at 12 and 24h post-operative. Also, the need for additional analgesics, the time (h) required to start patient mobilization and the presence of adverse effects were recorded. ResultsNo statistical differences were found between groups in pain intensity, using the VAS-Pain score at 12h [(Parecoxib vs. Dexketoprofen): 2.76(4.03) vs 2.97(4.34); p=0.39)], at 24h [(Parecoxib vs. Dexketoprofen): 2.47(4.62) vs 2.84(5.20); p=0.11)] or in the need for additional analgesics at 12h [(Parecoxib vs. Dexketoprofen): 4.21% vs 5.79%; RR=0.73, 95% CI: 0.33 to 1.77; p=0.31)] or at 24h [(Parecoxib vs. Dexketoprofen): 5.79% vs 4.21%; RR=1.38, 95% CI: 0.57 to 3.34; p=0.31)]. There were no differences in mobilization time or in the development of adverse effects. ConclusionThere are no differences concerning the effectiveness of parecoxib vs. dexketoprofen, in combination with paracetamol as additional analgesia in patients receiving neuraxial morphine, for postoperative pain relief in cesarean section.