Preemptive Analgesic Efficacy of Parecoxib for Reducing Postoperative Pain in Patients Undergoing Gynecological Surgery

Objective: This study aimed to evaluate the effectiveness of preemptive parecoxib in reducing postoperative pain following gynecological surgery. Materials and Methods: A double-blind, randomized study involved 168 patients undergoing laparotomy gynecological procedures, including total hysterectomy, adnexal surgery, and surgical staging, between November2023 and July 2024. Patients were randomly assigned to receive either intravenous parecoxib (n = 82) or normal saline (n = 86) 15 minutes before surgery. Postoperative pain was measured using a visual analog scale at 2, 6, 12, and 24 hours. Morphine consumption within the first 24 hours post-surgery was recorded, along with any adverse events related to parecoxib and the length of hospital stay. Results: Mean pain scores at 2, 6, 12, and 24 hours postoperatively were lower in the treatment group compared to the control group (5.3 vs. 5.7, p = 0.261; 3.7 vs. 5.0, p < 0.001; 3.3 vs. 5.1, p < 0.001; 3.5 vs. 4.0, p = 0.164, respectively). The mean 24-hour postoperative morphine consumption was significantly lower in the treatment group (4 ± 8 mg vs. 8 ± 5 mg, p < 0.001). No significant adverse events occurred between the groups. The total length of hospital stay was similar between the two groups (3.4 ± 1.8 vs. 3.5 ± 1.4 days, p = 0.698). Conclusion: Preemptive parecoxib significantly reduced pain at 6 and 12 hours post-surgery and reduced morphine use within 24 hours, with no significant effect on hospital stay duration in gynecological surgery.