ABSTRACT
Objective To evaluate the efficacy of intramuscular parecoxib for postoperative analgesia in patients undergoing total knee arthroplasty.Methods Fifty-four ASA Ⅰ-Ⅲ patients,aged 65-75 yr,scheduled for unilateral total knee arthroplasty,were randomly divided into 2 groups (n =27 each)∶ tramadol group (group T) and parecoxib group (group P).Total intravenous anesthesia was used in both groups.Group P received intramuscular injection of parecoxib 40 mg at 12 h before operation and 12,24,36,48,60 and 72 h after operation,and group T received tramadol 100 mg at the same time points.When VAS score was more than 3 after operation,intramuscular parecoxib 50 mg was given as rescue analgesic.The ineffective analgesia at rest and during activity was recorded.The time for knee range of motion to reach 90° and cardiovascular events were recorded.The ultrasonic inspection was performed on veins of the bilateral lower extremities at 7 and 14 days after operation for detection of vein thrombosis.Results Compared with T group,the rate of ineffective analgesia at rest and during activity was significantly decreased,the time for knee range of motion to reach 90° was shortened,and the incidence of deep vein thrombosis was significantly decreased (P ＜ 0.05 or 0.01),and no significant change was found in the incidences of cardiovascular events and intramuscular venous thrombosis in group P (P ＞ 0.05).Conclusion Parecoxib 40 mg injected intramuscularly before and after operation can significantly relieve postoperative pain,is helpful for the hip function rehabilitation and can reduce the occurrence of deep vein thrombosis in patients undergoing total knee arthroplasty.