Key result
Celecoxib resulted in a significantly lower analgesic effective rate compared to loxoprofen (68.6% vs 93.3%, p=0.0003) but reduced the rate of late-onset hemorrhage after the 11th postoperative day (0.0% vs 31.2%, p=0.049).
Why the study?
Does celecoxib reduce the risk of hemorrhage and provide good analgesic effect following tonsillectomy compared to loxoprofen?
Cohort (n=107)
No
Does celecoxib reduce the risk of hemorrhage and provide good analgesic effect following tonsillectomy compared to loxoprofen?
Celecoxib may reduce the risk of late-onset hemorrhage after tonsillectomy with fewer gastrointestinal side effects compared to loxoprofen, though it may require supplemental analgesia due to a weaker analgesic effect.
May be associated with lower late hemorrhage but inferior analgesia after tonsillectomy; leaves open confirmation in randomized trials.
Hemorrhage following tonsillectomy is still a major complication despite the progress in medical technology. Celecoxib is a selective COX-2 inhibitor and has a lower effect of platelet aggregation compared with conventional non-steroidal anti-inflammatory drugs (NSAIDs). We investigated whether or not the selection of celecoxib would reduce the risk of hemorrhage and provide a good analgesic effect following tonsillectomy in comparison with the use of loxoprofen (a conventional NSAID). We divided 107 cases of tonsillectomy into two groups by the kind of analgesic prescribed; the celecoxib group (n=55) and the loxoprofen group (n=52). Regarding the effective rate of the analgesic effect, the loxoprofen group scored 93.3% and the celecoxib group scored 68.6%. There was a significant difference between them (p=0.0003). Regarding side effects, the celecoxib group showed no side effects, whereas 8.0% of the loxoprofen group developed abdominal pain. There were no statistically significant differences between the changes in the VAS scale regarding the pain (p=0.834), the prescription periods of analgesic (p=0.485), the amount of food intake during the hospitalization (p=0.579), the rescue dosage rate (p=0.585), periods of usage (p=0.198) and the last dosage day. As for the tendency and the grade of postoperative hemorrhage, there were no statistically differences between the two groups (p=0.220). The rates of occurrence of late-onset hemorrhage (i.e. after the postoperative eleventh day) were 0.0% (0/11) in the the celecoxib group (n=11) and 31.2% (5/16) in the the loxoprofen group showing a statistically differences between them (p=0.049). Our results suggest that Celecoxib might reduce the risk of late-onset hemorrhage after the postoperative eleventh day with few side effects, so it could be a useful analgesic drug following tonsillectomy. However, it might be necessary to consider administration in combination with acetaminophen because Celecoxib has insufficient analgesic effect following tonsillectomy.
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Hirai et al. (2016) conducted a cohort in Tonsillectomy (n=107). Celecoxib vs. Loxoprofen was evaluated on Effective rate of analgesic effect (p=0.0003). Celecoxib resulted in a significantly lower analgesic effective rate compared to loxoprofen (68.6% vs 93.3%, p=0.0003) but reduced the rate of late-onset hemorrhage after the 11th postoperative day (0.0% vs 31.2%, p=0.049).
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