The Antinociceptive Effect of Local or Systemic Parecoxib…

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AnesthesiaAndAnalgesia, originally uploaded by rsdscrpsnews.

Anesth Analg 2005;101:807-811
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ane.0000166980.45162.1c
PAIN MEDICINE
The Antinociceptive Effect of Local or Systemic Parecoxib Combined with Lidocaine/Clonidine Intravenous Regional Analgesia for Complex Regional Pain Syndrome Type I in the Arm
Luiz-Cleber P. Frade, MD, Gabriela R. Lauretti, MD, MSc, PhD, Izabel C.P.R. Lima, MD, MSc, PhD, and Newton L. Pereira, B Pharm, MSc, PhD

Pain Clinic, Teaching University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil

Address correspondence and reprint requests to Gabriela R. Lauretti, MD, MSc, PhD, Rua-Campos Sales, 330, apto. 44, Ribeirão Preto-São Paulo 14015 110, Brazil. Address e-mail to grlauret@fmrp.usp.br.

We evaluated the efficacy of local or systemic parecoxib combined with lidocaine/clonidine IV regional analgesia in complex regional pain syndrome (CRPS) type 1 in a dominant upper limb. Thirty patients with CRPS type 1 were divided into three groups. The control group (CG) received both IV saline in the healthy limb and IV loco-regional 1 mg/kg of lidocaine + 30 µg of clonidine, diluted to a 10-mL volume with saline. The systemic parecoxib group (SPG) received a regional block similar to that administered to the CG but with systemic 20 mg of parecoxib, whereas the IV regional anesthesia with parecoxib group (IVRAPG) received an extra IV 5 mg of loco-regional parecoxib compared with the CG. The block was performed once a week for 3 consecutive weeks. Analgesia was evaluated by the 10-cm visual analog scale (VAS) and rescue analgesic consumption. The IVRAPG showed less daily ketoprofen (milligrams) consumption in the second and third weeks compared with the other groups (P < 0.05). The IVRAPG also showed less ketoprofen consumption when comparing the first and second week with the third week (P < 0.05). The VAS score comparison among groups revealed that groups were similar during the first and second week observation, although the IVRAPG showed smaller VAS scores in the third week compared with both CG and SPG (P < 0.05). We conclude the IV 5 mg of parecoxib was an effective antiinflammatory drug combined with clonidine/lidocaine loco-regional block in CRPS type 1.

For the original article online, please click here: http://www.anesthesia-analgesia.org/cgi/content/abstract/101/3/807

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