A Comparative Study to Evaluate Selective COX-2 Inhibitors Alone or in Combination with Pregabalin Given Pre-Operatively For Pain Management in Total Knee Arthroplasty.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Pain control during immediate post operative period is necessary in Total Knee Arthroplasty(TKA) patients for early mobilization. The use of COX-2 inhibitors preoperatively has shown significant reduction in opiod usage and in pain relief post operatively. Furthermore, some studies have suggested that the addition of pregabalin preoperatively has led to further reduction in postoperative pain and opiod use.The aim of this study is to compare pain scores in a group of patients who receive a single preoperative dose of pregabalin combined with a COX-2 inhibitor and a control group which receives only COX-2 inhibitor. A prospective randomiazed control study was carried in which 200 patients undergoing primary unilateral total knee replacement received preoperatively either 200 mg celecoxib alone (Group A, n=100) or combination of celecoxib 200 mg plus 75 mg of Pregabalin (Group B n=100) approximately one hour before the surgery. All patients underwent primary unilateral TKA under spinal analgesia using the standard medial parapatellar approach under tourniquet. Pain was assessed pre operatively, after 6 hours, 24 hours, 48 hours post operatively using Visual Analogue scale (VAS) in all patients.Both the groups were comparable regarding the demographic parameters and showed a significant postoperative pain relief at the end of 48 hours (p<0.05). The mean preoperative VAS score in group A was 5.82 which decreased to 2.86 after 48 hours (p<0.05). Similarly, mean preoperative VAS score in group B was 5.12 which decreased to 2.05 after 48 hours after surgery. No significant intergroup difference in functional outcome was noted. However, mean cumulative opioid consumption was lower in group B compared to group A (p<0.05).Preoperative administration of celecoxib lowers the pain scores in the post operative period. Addition of pregabalin reduces the postoperative pain significantly in TKA patients.
Authors and Affiliations
Dr. Ganaparthi Kamalahassan, Dr. A. V. Gurava Reddy, Dr. Krishna Kiran Eachempati, Dr. Sukesh Rao Sankineani, Dr. Saketh Kolla
Keywords
Related Articles
- EP ID EP593490
- DOI 10.9790/0853-1603039698
- Views 88
- Downloads 0
Sites of Infections and choice of antimicrobial drugs in acute leukemia in Indian Children
In this study children with acute leukemia were evaluated for the incidence and sites of infection, correlation with absolute neutrophil count, causative organisms and to standardize the initial empirical anti microbial...
Balantidium Coli: Rare Urinary Pathogen or Fecal Contaminant in Urine? Case Study And Review
Balantidium coli is a known fecal pathogen causing dysentery, abdominal pain and weight loss. It can though rarely cause urinary tract infection. Differentiating between the two is very essential as many urinary samples...
Gorlin-Goltz syndrome – a case report
Gorlin-Goltz syndrome or basal cell nevus bifid rib syndrome is a genetic disorder characterized by the presence of multiple odontogenic keratocysts. Odontogenic keratocyst (OKC) is a developmental cyst of epithelial ori...
Clinical and Radiological Evaluation of Deviated Nasal Septum in Classifying and Surgical Management of the Deviated Septums.
Introduction:Nasal obstruction is one of the most common problems bringing patient to an ENT surgeon and deviated nasal septum is the most common cause of the problem. Yet there is no universally accepted classification...
Application of Endodontic Imaging Modalities in Forensic Personal Identification: A Review
Dental identification of a deceased individual is a core task in forensic odontology. The accurate recording of clinical dental procedures has become more important over time because of the increasing trend of lawsuits w...