1886 PERIOPERATIVE CELECOXIB REDUCES NARCOTIC USE IN PATIENTS UNDERGOING TESTICULAR SURGERY: A RANDOMIZED DOUBLE-BLIND CONTROLLED TRIAL

Field: Medicine (Health Sciences)

You have accessJournal of UrologyInfertility: Therapy1 Apr 20131886 PERIOPERATIVE CELECOXIB REDUCES NARCOTIC USE IN PATIENTS UNDERGOING TESTICULAR SURGERY: A RANDOMIZED DOUBLE-BLIND CONTROLLED TRIAL Akanksha Mehta, Wayland Hsiao, Peggy King, and Peter Schlegel Akanksha MehtaAkanksha Mehta New York, NY More articles by this author , Wayland HsiaoWayland Hsiao Atlanta, GA More articles by this author , Peggy KingPeggy King New York, NY More articles by this author , and Peter SchlegelPeter Schlegel New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2305AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The use of celecoxib has been advocated as part of a multimodal approach to postoperative analgesia, to reduce inflammation, pain, and narcotic requirement. However, the safety and efficacy of this drug has not been investigated in urologic patients. The aim of this study was to evaluate the effect of daily perioperative celecoxib on patient-reported pain control and narcotic use following surgical sperm retrieval. METHODS A randomized, placebo-controlled trial of perioperative celecoxib was offered to all patients undergoing elective, outpatient microsurgical testicular sperm extraction (TESE) from 9/2011-9/2012 with informed consent (NCT01323595). Participants were prospectively randomized to receive 200 mg of celecoxib or placebo b.i.d. in a double-blind fashion, initiated the night prior to surgery, and continued for six days thereafter. All participants were asked to complete a postoperative questionnaire recording their pain level on an 11-point visual analog scale (0-10). The use of acetaminophen/hydrocodone for supplemental pain control from postoperative day (POD) #1 to #7 was recorded. Differences in pain scores and narcotic use between the two groups of patients were compared using Student's t-test. A p-value <0.05 was considered statistically significant. RESULTS At one-year interim analysis, 35/78 (45%) of eligible participants had returned study questionnaires; one patient was excluded due to unclear responses. 16 patients were randomized to celecoxib while 18 received placebo. Patients in each treatment arm were comparable with respect to age and proportion undergoing unilateral vs. bilateral TESE. Patients using celecoxib had a significantly lower narcotic use in the postoperative period than those using placebo (6 vs. 16 pills, p=0.02). When analyzed on a day-by-day basis, a statistically significant difference in POD#1 and POD#2 patient-reported pain scores (4 vs. 6, p<0.05 and 3 vs. 5, p=0.03) and narcotic use (1 vs. 5 pills, p<0.01 and 2 vs. 4 pills, p=0.02), was seen between the celecoxib and placebo groups, respectively. No complications were identified. The trial was terminated early because of the results of the interim analysis. CONCLUSIONS Twice daily celecoxib use, started preoperatively, significantly reduces patient-reported postoperative pain and narcotic use, especially in the early postoperative period. A short course of celecoxib may be safely used as a part of multimodal postoperative analgesia in patients undergoing testicular surgery including surgical sperm retrieval. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e773-e774 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Akanksha Mehta New York, NY More articles by this author Wayland Hsiao Atlanta, GA More articles by this author Peggy King New York, NY More articles by this author Peter Schlegel New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...