The effect of etoricoxib premedication on postoperative analgesia requirement in orthopedic and trauma patients

Objectives: We hypothesized that etoricoxib premedication would reduce the need for additional opioids following orthopedic trauma surgery. Methods: A double blind, controlled study, conducted in King Fahd University Hospital, King Faisal University, Dammam, Kingdom of Saudi Arabia. After obtaining the approval of the Research and Ethics Committee and written consent, 200 American Society of Anesthesiology grade I II patients that underwent elective upper limb or lower limb fracture fixation surgeries during the period from August 2005 to October 2007 were studied. Patients were randomly premedicated using 120 mg of etoricoxib or placebo (n=100, each). To alleviate postoperative pain, a patient controlled analgesia device was programmed to deliver one mg of morphine intravenously (lockout time, 6 minutes). Visual analog scale and total postoperative morphine consumption over 24 hours and the adverse effects were recorded. Results: One hundred patients in each group completed the study period. Etoricoxib premedication provides a statistically significant postoperative morphine sparing effect over 24 hours postoperatively. Total morphine consumption was 44.2 (8.2) in the placebo and 35.1(7.0)mg in the etoricoxib groups (p 0.001). The incidence of nausea and vomiting requiring treatment was lower in the etoricoxib group, (p=0.014). The postoperative blood loss was similar in both groups. Conclusion: Etoricoxib is a suitable premedication before traumatic orthopedic surgery as it enhanced postoperative analgesia and reduced the need for morphine