The Preemptive Analgesic Effects of Rofecoxib after Spinal Fusion Surgery

Abstract

Background: The administration of nonsteroidal antiinflammatory drugs (NSAIDs) can significantly affect spinal fusion for the multimodal management of postoperative pain. Moreover, cyclooxygenase-2 (COX-2) inhibitors may offer an alternative to conventional NSAIDs in the management of pain after spine stabilization surgery. This study was designed to determine the analgesic efficacy of different doses of rofecoxib. Methods: We evaluated 60 inpatients undergoing one level spinal fusion surgery by a single surgeon. All patients received patient-controlled analgesia (PCA) morphine. Patients were divided into four groups. Preoperatively, they were given oral rofecoxib (25 mg, 50 mg, 75 mg), or oral placebo. Outcome measures inc1uded visual analogue scale (VAS) scores and 24 h morphine consumption at seven time periods during the first 24 h postoperatively. Results: The total dose of morphine was significantly larger in the control and the 25 mg rofecoxib groups than in the other two groups. Morphine consumption was similar in groups receiving 50 mg or 75 mg of rofecoxib. No significant differences in pain scores were observed between the four groups. Conclusions: The effective doses of rofecoxib for significant analgesia are 50 mg and 75 mg after spinal fusion surgery.