Preemptive analgesic effect of low doses of celecoxib is superior to low doses of traditional nonsteroidal anti-inflammatory drugs

J Craniofac Surg. 2012 Mar;23(2):526-9. doi: 10.1097/SCS.0b013e31824cd4fb.

Abstract

Purpose: The purpose of the study was to compare the preemptive analgesic effect of celecoxib, a cyclooxygenase 2 inhibitor, with a traditional nonsteroidal anti-inflammatory drug, ibuprofen, in patients after minor oral surgery procedures.

Patients and methods: This randomized, double-blind, placebo-controlled, prospective clinical trial was conducted over an 8-month period. Participants were randomly allocated to receive a standard oral dose of 200 mg celecoxib, 400 mg ibuprofen, or a placebo containing lactose, preemptively 1 h before surgery. Using a patient diary, patients recorded pain intensity, pain relief, and global evaluations throughout the 24-hour period after dosing. The overall analgesic effect, onset of action, peak effect, and duration of effect were evaluated, with the primary end point being total pain relief over 8 hours. The safety profile was assessed on the basis of physical findings and spontaneous reports of adverse experiences.

Results: The results showed that compared with ibuprofen, celecoxib had superior analgesic effects on all measures of analgesic efficacy, including overall analgesic effect (total pain relief over 8 hours: 18.1 vs 12.2, P < 0.001), time to onset of effect (30 vs 60 minutes, P = 0.003), peak pain relief (score, 2.7 vs 2.4, P < 0.05), and duration of effect (>24 vs 7.0 hours, P < 0.001). The safety profile was similar across all treatment groups.

Conclusions: This is the first reported study that demonstrates the superior analgesic effect of celecoxib, for the release of acute postoperative pain following surgery, when compared with the traditional nonsteroidal anti-inflammatory drug, ibuprofen. There was no safety compromise when celecoxib was used in lower doses to provide analgesia for patients who need minor surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Celecoxib
  • Cyclooxygenase 2 Inhibitors / administration & dosage*
  • Double-Blind Method
  • Female
  • Humans
  • Ibuprofen / administration & dosage*
  • Least-Squares Analysis
  • Male
  • Middle Aged
  • Molar, Third / surgery*
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Placebos
  • Proportional Hazards Models
  • Prospective Studies
  • Pyrazoles / administration & dosage*
  • Sulfonamides / administration & dosage*
  • Tooth Extraction*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2 Inhibitors
  • Placebos
  • Pyrazoles
  • Sulfonamides
  • Celecoxib
  • Ibuprofen