Journal of Anesthesiology and Pain

Background: Efficacy of preoperative oral administration of celecoxib to prevent postoperative pain has been proved in several studies. Also some studies were done about efficient and enough dose to control postoperative pain but there is no agreement about administration in one single dose or administration in short divided doses. In this study, we conducted to evaluate the clinical efficacy of two different doses (200 mg and 400 mg) of celecoxib, as selective cyclooxygenase-2 inhibitors, on acute pain severity after orthopedic surgeries.
  Methods: In this randomized clinical trial, 60 patients candidate leg fracture fixation under spinal anesthesia were enrolled. After taking informed consent, The patients were assigned randomly between three groups (group A: 400 mg at night before surgery, group B: 200 mg night before surgery and 200 mg in the morning and group C: no premedication). The severity of pain was evaluated by VAS(visual analogue scale),the time of anlgesic request by the patient and amounts of opioids administered during 24 hours after surgery was recorded and compared.
Results: There was no statistically significant difference between three groups regarding to age, sex, and duration of operation time. The mean pain severity after 6 hours (post-operation) was the same in three groups. The mean of time of analgesic  request after operation was 196.5±121 minute in patients receiving 400 mg celecoxib in which it was significantly greater than the others (p=0.01). the mean of opioid consumption in patients receiving 400 mg celecoxib was less than the other groups but it didn't show any significant difference . 
Conclusion: Our study showed that administration of 400 mg celecoxib single dose was effective to postpone  time of opioid request after leg fracture operation under spinal anesthesia, but in comparison with two divided doses of  200 mg  celecoxib, it didn't have any significant difference on postoperative severity of pain. Also single dose (400mg) reduced the amounts of opioid consumption compared to two divided 200mg dose.