Efficacy of parecoxib for reducing pyelovenous backflow pain during retrograde intrarenal surgery

Objective: The goal of this paper is to evaluate the safety and efficacy of perioperative parecoxib, a cyclooxygenase-2 inhibitor in reducing transient postoperative pyelovenous backflow pain in patients undergoing retrograde intrarenal surgery (RIRS). Materials and Methods: We instituted a change in our institutional clinical practice starting in January 2016. Since January 2016, all patients undergoing RIRS were administered perioperative intravenous parecoxib. Patients with a history of chronic renal failure (Cr over 2.5) or coronary heart disease did not receive parecoxib. The numerical scale NRS (Numerical rating scale) was recorded after postoperative conscious recovery within 24 h of the postoperative hospitalization. The NRS values were compared with a matched cohort of patients treated with RIRS at our center before January 2016 initiation of parecoxib administration to RIRS patients. Results: A total of 116 patients received Parecoxib during RIRS between January 2016 and August 2016. We found that parecoxib infusion was associated with significantly decreased of NRS. Out of 243 patients, 160 patients treated with parecoxib received an NRS of 1.57 points versus 127 of 243 matched controls who had an NRS of 3.32 points (P < 0.0001). The proportion of NRS >4 score in the patients with parecoxib infusion is much lower than those patients who did not receive Parecoxib (9% vs. 30%). Conclusion: Use of perioperative parecoxib during RIRS is associated with a significant reduction in transient postoperative pyelovenous backflow pain and increased operation quality.