Key result
A systematic review of 8 studies showed rofecoxib and parecoxib were largely effective for post-adenotonsillectomy pain relief, while results for celecoxib were conflicting.
Why the study?
Do selective COX-2 inhibitors improve analgesic efficacy in paediatric patients undergoing adenotonsillectomy?
Systematic Review
Do selective COX-2 inhibitors improve analgesic efficacy in paediatric patients undergoing adenotonsillectomy?
Selective COX-2 inhibitors like rofecoxib and parecoxib offer effective and well-tolerated post-operative pain relief for paediatric adenotonsillectomy, though data heterogeneity limits definitive conclusions.
Answers are grounded in this paper and cite their sources.
COX-2 inhibitors may aid post-adenotonsillectomy analgesia in children with good tolerability; leaves open definitive efficacy of current oral agents.
Background: A systematic review of the analgesic efficacy of selective cyclooxygenase-2 (COX-2) inhibitors in paediatric adenotonsillectomy based on subjective pain scores, adjunct analgesic requirements and time to recovery was performed. Additional analysis was performed of side effects to treatment and patient satisfaction. Methods: A systematic search was performed using the PubMed, MEDLINE and EMBASE databases. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies that measured the efficacy of selective COX-2 inhibitors were included for qualitative analysis. Results: Eight studies (seven randomised controlled trials and one prospective cohort study) were included for analysis of rofecoxib, parecoxib and celecoxib. Rofecoxib and parecoxib were shown to be largely effective analgesic agents for post-adenotonsillectomy pain. Results were conflicting for celecoxib. Conclusions: The available evidence suggests that COX-2 inhibitors offer some benefit in post-adenotonsillectomy pain relief and are well tolerated. Paucity and heterogeneity of data make definitive conclusions difficult. Further research looking specifically at currently available oral agents in the post-operative setting will be of clinical relevance and potential benefit for this common paediatric procedure.
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Stokes et al. (2018) conducted a systematic review in paediatric adenotonsillectomy. Selective cyclooxygenase-2 (COX-2) inhibitors was evaluated on analgesic efficacy based on subjective pain scores, adjunct analgesic requirements and time to recovery. A systematic review of 8 studies showed rofecoxib and parecoxib were largely effective for post-adenotonsillectomy pain relief, while results for celecoxib were conflicting.
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