The efficacy of oral celecoxib for acute postoperative pain in face-lift surgery

JAMA Facial Plast Surg. 2014 Sep-Oct;16(5):306-9. doi: 10.1001/jamafacial.2014.351.

Abstract

Importance: Exploring methods of potentially improving patient comfort and pain control in cosmetic facial surgery.

Objective: To examine the effects of celecoxib in reducing pain and possible opioid consumption following face-lift surgery.

Design, setting, and participants: We reviewed the medical records of 100 patients: 50 consecutive patients who underwent a face-lift without receiving perioperative celecoxib and 50 patients who underwent face-lift and received immediate preoperative and standing postoperative celecoxib.

Main outcomes and measures: In addition to demographic information, the following outcome measures were recorded for each group: visual analog scale patient-reported pain, acetaminophen and/or opioid consumption rates, and related analgesic adverse effects.

Results: The participants in the noncelecoxib vs celecoxib groups had similar demographic characteristics: mean age, 59.6 vs 57.9 years; mean BMI, 23.3 vs 22.3; history of chronic pain or opioid use, 7 (14%) vs 6 (12%); and 94% of both groups were women. Postoperative pain scores were higher in the noncelecoxib vs celecoxib groups; mean (SD) overall pain score was 3.88 (2.20) vs 2.31 (2.36) (P < .001). The noncelecoxib group had a higher number of postoperative opioid doses than did the celecoxib group: 9.40 (4.30) vs 5.18 (4.58) (P < .05). The noncelecoxib group had a higher incidence of postoperative nausea and vomiting: 12 (24%) vs 0 in the celecoxib group.

Conclusions and relevance: Preemptive treatment with oral celecoxib appears to be effective in decreasing acute postoperative pain and opioid consumption in patients undergoing face-lift. Given the well-documented adverse effects of opioids, celecoxib is a desirable alternative.

Level of evidence: 3.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Pain / drug therapy*
  • Administration, Oral
  • Adult
  • Aged
  • Analgesics, Opioid / therapeutic use
  • Celecoxib
  • Cyclooxygenase 2 Inhibitors / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Postoperative Care
  • Preoperative Care
  • Pyrazoles / therapeutic use*
  • Retrospective Studies
  • Rhytidoplasty*
  • Sulfonamides / therapeutic use*
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Cyclooxygenase 2 Inhibitors
  • Pyrazoles
  • Sulfonamides
  • Celecoxib