Improving the analgesic efficacy of intrathecal morphine with parecoxib after total abdominal hysterectomy.

Abstract

The addition of parecoxib to intrathecal morphine and bupivacaine may improve analgesia and reduce morphine's opioid-related side effects. In this prospective, double-blind, randomized, placebo-controlled trial, total abdominal hysterectomy patients received either IV normal saline or parecoxib 40 mg before receiving intrathecal bupivacaine and morphine 0.2 mg. Twelve hours later, this administration was repeated. Patients were observed for 48 h. The addition of parecoxib to intrathecal morphine and bupivacaine significantly reduced cumulative morphine consumption, Visual Analog Pain scores, and increased patient satisfaction for 24 h postoperatively without an obvious decrease of adverse side effects. Perioperative parecoxib enhanced the postoperative analgesia of intrathecal morphine and bupivacaine and improved patient satisfaction.