Celecoxib and ketoprofen for pain management during tonsillectomy: a placebo-controlled clinical trial.

Abstract

To evaluate the efficacy and safety of celecoxib and ketoprofen in pain management during tonsillectomy in 120 patients. The study was randomized, double-blind, and placebo-controlled with parallel groups. Sixty minutes before anesthesia induction and 12 hours after, the patients received a 200-mg celecoxib, a 100-mg ketoprofen, or a placebo capsule. After discharge, patients were prescribed either celecoxib or ketoprofen capsules to be taken every 12 hours. During the first 24 hours, the need for rescue analgesic was less in the ketoprofen-group (5 [1-9]) doses (median [range]) than in the placebo-group (6 [1-13]) ( P = 0.021), but similar to the celecoxib-group (5 [2-14]). After discharge, the cessation of pain during eating occurred earlier in the celecoxib-treated patients, after 10 (1-17) days, than in the ketoprofen-treated patients, after 12 (1-21) days, ( P = 0.008). One celecoxib-treated patient and 6 ketoprofen-treated patients ( P = 0.013) needed electrocautery to stop postoperative bleeding. Ketoprofen provided a better initial analgesic efficacy but after discharge the recovery with celecoxib was faster and the incidence of secondary hemorrhages was lower. Celecoxib seems to be more effective and safe than ketoprofen for pain management after discharge in patients with tonsillectomy.