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In the name of God

In the name of God. Celecoxib as a pre-emptive analgesia in arthroscopic knee surgery; a triple blinded randomized controlled trial. Mohsen Mardani-Kivi, M.D. Orthopedic Department, Guilan University Of Medical Sciences.

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In the name of God

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  1. In the name of God

  2. Celecoxib as a pre-emptive analgesia in arthroscopic knee surgery; a triple blinded randomized controlled trial Mohsen Mardani-Kivi, M.D. Orthopedic Department, Guilan University Of Medical Sciences

  3. pre-emptive analgesia not only controls pain but also may result in the reduction of opioid consumption and related side effects following orthopedic surgeries. Background

  4. COX-2 inhibitors inhibitory effects in PG synthesis, & reduce hyperalgesia status following surgical traumas • Celecoxibnoside effects such as anti-PLT function, increased risk of GIB, Increased risk of CAD Background

  5. To examine the effects of celecoxibin reducing pain following the arthroscopic knee surgeries: ACL reconstruction and partial meniscectomy. The purpose of the study

  6. Methods and Materials:

  7. Methods and Materials: Variables were assessed at: 6 hour post-op, and 24 hour post-op

  8. Flowchart of the study

  9. The patients weresimilar in both groups with respect to demographic characteristics (such as age, gender, operation time, weight and BMI) (P>0.05). Results

  10. Patients in Celecoxib group experienced less pain than Placebo group (p<0.0001). • Such significant difference was also observed in both ACL and M subgroups. Results:

  11. Results: Table2. Pain intensity in subgroups at 6hr and 24hr according to VAS C: Celecoxib group P: Placebo group

  12. analgesics used in celecoxib group was significantly lower than in placebo group (P<0.05). Results: Opioid consumption

  13. Table3. The comparison of opioid consumption between subgroups Results: Opioid consumption

  14. All of the observed adverse effects were similar in both groups. • Nausea was observed among 12 cases (21.1%) in Celecoxib and 21 patients (35%) in placebo group at 24hr follow-up (p=0.11). • The drowsiness and dizziness scores were not significantly different between the two groups. Results: adverse effects

  15. Discussion

  16. Celecoxib effect is dose related and clinical trial studies recommend celecoxib 400 mg to control acute pain (as we applied). Discussion

  17. The results of the present study  celecoxib may decrease pain and aopioid consumption. • Ekman et al. / 2006 / partial meniscectomy / 200 patients / significantly reduce morphine consumption • Huang et al. / 2008 / 40 patients / TKA / decreased pain and opioids nd side effects. Discussion

  18. On the contrary: • Boonriong et al. / 102 patients / ACL / reported no significant differences in pain reduction and analgesic consumption between the celecoxib and placebo groups. Discussion

  19. Celecoxib potential adverse effects on bone growth by interfering in bone morphogenetic protein (BMP) signaling system. • BMP may also plays certain role in early tendon formation and any interference in its signaling system during post operation time may also delay tendon repair. Discussion

  20. Discussion

  21. a larger population • vast range of different side effects • further long term follow-up research studies investigating the conclusive evidence of the effects of COX-2 inhibitors on bone formation and tendon repair recommendation

  22. Any suggestions?

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