Affiliation

• ¹Department of Anesthesia, Bnai Zion Medical Center, 47 Golomb St. Haifa, Israel
• ²The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Efron St. Haifa, Israel
• ³HPB & Liver Transplant Surgery Department, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, United Kingdom
• ⁴Department of Urology, Bnai Zion Medical Center, 47 Golomb St. Haifa, Israel
• ⁵Department of Cardiothoracic Surgery, Carmel Medical Center, 7 Michal St. Haifa, Israel
• ⁶Department of General Surgery, Bnai Zion Medical Center, 47 Golomb St. Haifa, Israel
• ⁷Department of Gastrointestinal Medicine, Barts Health NHS Trust, W Smithfield, London, EC1A 7BE, United Kingdom
• ⁸Department of General Surgery, Bnai Zion Medical Center, 47 Golomb St. Haifa, Israel

Corresponding Author

Mostafa Somri, MD, Bnai Zion Medical Center, 47 Golomb St. Haifa, Israel 31048, Tel: +97248359230; E-mail: somri_m@yahoo.com

Citation

Somri, M., et al. Multimodal Analgesia in Inguinal Hernia Repair Using a Cyclooxygenase-2-Specific Inhibitor: A randomised controlled trial. (2016) J Anesth Surg 2(2): 61-65.

Copy rights

©2016 Somri, M. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.

Keywords

Abstract

Aim: To determine whether preoperative use of the highly cyclooxygenase-2-specific inhibitor rofecoxib combined with spinal anesthesia offers superior postoperative analgesia compared to spinal anesthesia alone.
Methods: Single-centre, randomised, double-blinded, placebo-controlled trial, including 40 adult patients undergoing elective open inguinal hernia repair. Both the control (n = 20) and treatment (n = 20) groups received 10-12 mg of bupivacaine as local anesthesia and 25 μg of fentanyl as spinal anesthesia. Additionally, control patients received oral placebo, whereas the treatment group received 50 mg of oral rofecoxib 2 hours preoperatively.
Results: Resting pain scores were significantly lower in the treatment group at 4, 16 and 24 hours postoperatively, as well as on discharge (p < 0.05). Pain scores on active straight-leg raise were significantly lower at 16 hours, 24 hours, and on discharge (p < 0.01, p < 0.05 and p < 0.05 respectively). Time to first analgesic dose was longer (p < 0.001) and average analgesic doses were lower (p < 0.001) in the treatment group. Finally, side-effect profiles were similar between groups.
Conclusions: Preoperative rofecoxib administration in combination with spinal anesthesia is superior to spinal anesthesia alone in controlling pain after inguinal hernia repair.