Epidural injection of cyclooxygenase-2 inhibitors has been suggested as a useful therapeutic modality in pain management in animal studies and clinical settings. Direct epidural administration of parecoxib, a highly selective cyclooxygenase-2 inhibitor, may have advantages over its parenteral administration regarding required dose, side effects, and efficacy. However, no animal studies have been performed to investigate the possible neurotoxicity of epidurally injected parecoxib. Therefore, the present study was performed to assess the neurotoxicity of epidurally injected parecoxib in rats. Rats (n=45) were randomly divided into three groups: normal saline group (group N, n=15), ethanol group (group E, n=15), and parecoxib group (group P, n=15). 0.3 mL of epidural parecoxib (6 mg) and the same volume of epidural ethanol or normal saline were injected into the epidural space. Neurologic assessment was performed 3, 7 and 21 days after the injection by pinch toe testing. Histologic changes were evaluated for vacuolation of the dorsal funiculus, chromatolytic changes of the motor neurons, neuritis, and meningeal inflammation. All rats in groups N and P showed normal response to pinch-toe testing and had a normal gait at each observation point. Histological examination showed no evidence suggestive of neuronal body or axonal lesions, gliosis, or myelin sheet damage in group N or P at any time. However, all rats in group E showed sensory-motor dysfunction, behavioral change, or histopathological abnormalities. No neurotoxicity on the spinal cord or abnormalities in sensorimotor function or behavior was noted in rats that received epidural parecoxib.
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http://dx.doi.org/10.1016/j.neuro.2011.05.011 | DOI Listing |
Drug Des Devel Ther
October 2022
Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Purpose: Postoperative pain after open hepatectomy is significant. Preoperative coagulopathy limits the use of epidural analgesia, the gold standard for pain control in open abdominal surgery. Erector spinae plane block (ESPB) is a novel regional anesthesia technique that has been shown to provide effective analgesia in abdominal surgery.
View Article and Find Full Text PDFBMC Pharmacol Toxicol
June 2021
Department of Anesthesia, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Background: Chronic post-surgical pain (CPSP) has a negative impact on the recovery, quality of life, and physical functioning of elderly patients. This study aimed to test the superiority of parecoxib vs. placebo in preventing chronic post-hepatectomy pain in elderly patients under combined general-epidural anesthesia.
View Article and Find Full Text PDFInt J Surg
June 2021
Department of General Surgery, Peking University First Hospital, Beijing, 100034, China. Electronic address:
Background: Parecoxib, a selective cyclooxygenase-2 inhibitor, is a potential alternative analgesic to reduce opioid consumption after Pancreaticoduodenectomy (PD). Further, the safety and efficacy of long-term use of parecoxib for patients after PD remain a major concern.
Materials And Methods: In this single-center, randomized clinical trial, 134 patients undergoing open PD were randomized into the parecoxib group (group P) and control group (group C) at a 1:1 ratio.
BMJ Open
February 2021
School of Medicine, National Yang-Ming University, Taipei, Taiwan
Objective: The efficacy of parecoxib as pre-emptive analgesia still remains controversial. This study aimed to investigate how pre-emptive analgesia with parecoxib affected postoperative pain trajectories over time in patients undergoing thoracic surgery.
Design: Retrospective cohort study.
J Invest Surg
July 2021
Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
Objective: To investigation effects of the combination use of epidural blockade and parecoxib in postoperative recovery of colorectal cancer (CRC) patients.
Methods: The present prospective single-blinded study included 186 CRC patients who received radical resection during April 2016 to December 2017. All patients were randomized into 3 different groups, the epidural blockade group, the combined-group with both epidural blockade and pre-intravenous injection of parecoxib, and the control group.
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