Effect of celecoxib combined with thoracic epidural analgesia on pain after thoracotomy.

BACKGROUND: Thoracotomy results in severe postoperative pain potentially leading to chronic pain. We investigated the potential benefits of oral celecoxib on postoperative analgesia combined with thoracic epidural analgesia (TEA). METHODS: Forty patients undergoing thoracotomy were included in this prospective, randomized, double-blind, placebo-controlled study. General anaesthesia was standardized. Patient-controlled epidural analgesia (T4-T5) was used during 48 h after surgery (ropivacaine 2 mg ml(-1) with sufentanil 0.5 microg ml(-1)). Patients were allocated to receive oral celecoxib or placebo from the evening before surgery until 48 h after operation. Postoperative pain scores, respiratory function, and morbidity were compared between the two groups. RESULTS: Postoperative pain scores at rest (P=0.026) and during coughing (P=0.021) were lower and patient satisfaction was greater (P=0.0033) in the celecoxib group. Consumption of the local anaesthetic solution was comparable between groups. Postoperative restrictive pulmonary syndrome and morbidity were comparable between groups. CONCLUSIONS: Celecoxib improves postoperative analgesia provided by TEA after thoracotomy.