Please select the eligibility criteria that correspond to the clinical trial below.
Title: Etoricoxibe - Preemptive and Postoperative Analgesia for Abdominal and Thoracic Surgery
Brief Summary: This randomised placebo controlled double-blinded bicentre study (phase III) was designed to evaluate the preemptive and postoperative analgetic impact of etoricoxibe in open abdominal and thoracic surgery. Etoricoxib selectively inhibits isoform 2 of cyclo-oxigenase enzyme (COX-2).

Therefore 120 patients (ASA-risk 1-2) with upcoming abdominal or thoracic surgery should be included into this study. Patients are randomly allocated to either the preemptive or the postoperative Etoricoxibe group. These two groups are divided each into two arms. Preemptive group patients get Etoricoxibe either twice (before and after surgery) or just a single preoperative dose. Postoperative group patients get placebo before surgery and either a drug application or a placebo again after surgery (so called 2x2 factorial study design).

Cumulative use of morphine as assessed within first 48 hours after surgery is the primary trial outcome indicating the analgesic potency of Etoricoxibe.

In addition, changes in patients level of sensibilisation will be measured with help of quantitative sensory testing (a standardised procedure) before and after surgery (secondary outcome). In addition pharmacogenetic testing will provide information about genetic aberrations (so called polymorphisms) of the patients enzymes that should be compared to the individual reaction regarding Etoricoxibe.

The results will give hint about the analgesic impact of etoricoxibe in acute postoperative pain. There will be findings for preemptive analgesia and nerval processes. All this could lead to an improvement of postoperative pain relief while administrating preemptively a COX-2 selective inhibitor before surgery.


Options:
A: Inclusion Criteria:

* Healthy volunteers between 18-28 years old
* Clinical and radiographic diagnosis of impacted mandibular third molars, which the surgical approach may include flap and osteotomy procedures.
* surgery classified as simple to moderate
* Voluntary acceptance of written consent, previously approved by institutional ethics committee

Exclusion Criteria:

* Prior administration of analgesic or anti-inflammatory drugs
* History of drug dependence
* History of allergic reactions to any of the drugs selected, or local anesthetics
* Simultaneous presence of oral pathologies that may interfere with the surgical procedure
B: Inclusion Criteria:

* Scheduled for unilateral, primary Total Hip Arthroplasty (THA)
* Age \> 18
* ASA 1-3.
* BMI \> 18 and \< 40
* Women in the fertile age must have negative urine HCG pregnancy test
* Patients who gave their written informed consent to participating in the trial after having fully understood the contents of the protocol and restrictions.

Exclusion Criteria:

* Patients who cannot cooperate with the trial.
* Concomitant participation in another trial
* Patients who cannot understand or speak Danish.
* Daily use of strong opioids (tramadol and codein are accepted)
* Patients with allergy to the medicines used in the trial.
* Contraindications against NSAID, for example previous ulcer, heart failure, liver failure, or renal failure (eGRF \< 60 ml/kg/1,73m2), known thrombocytopenia (\<100 mia/L)
* Patients suffering from alcohol and/or drug abuse - based on the investigator's judgement.
C: Inclusion Criteria:

* Programmed abdominal or thoracic surgery
* Patients \> 18 yrs
* Patients are aware of German language
* Participation is voluntary
* ASA-risk class 1-2 (American Society of Anesthesiologists guidelines)

Exclusion Criteria:

* Severe cardiac, pulmonary, renal or neurologic disease
* ASA risk III and IV
* Insulin dependent Diabetes mellitus
* Polyneuropathy
* Chronic pain
* Use of analgesic drugs
* Ulcus duodeni
* Ulcus ventriculi
* Time after intestinal bleeding
* Allergy reactions towards coxibes or coxibe-like drugs
* Pregnancy and lactation
* Severe hepatic disease (Albumin \< 25 g/l or Child-Pugh-Score ≥ 10)
* Children and Teenager \< 16 years
* Chronic intestinal inflammation
* Heart failure (NYHA II - IV)
* Inbalancend arterial hypertension
D: Inclusion Criteria:

* ASA I-III
* weight (kilos) over 40 kg
* height (centimeters) over 155 cm
* non-anemic
* indication for primary TKA (total knee arthroplasty)

Exclusion Criteria:

* history of asthma
* peptic ulcer
* severe hepatic or renal dysfunction
* neuropathies
* bleeding disorders
* uncooperative
* drug abuse
* sensibility to etoricoxib
* paracetamol or morphine
* long acting nonsteroidal antiinflammatory drugs (NSAID) in the last 4 days preoperative
* cerebrovascular and peripheric vascular disease
* arterial hypertension (HTA) not adequately controlled
* congestive heart failure.

Answer: C