• Peipei Li, Xiaodong Zheng, Yumin Wu, and Jiwen Peng.
• Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou, China.
• J. Matern. Fetal. Neonatal. Med. 2021 Nov 1; 34 (21): 3488-3495.

IntroductionThe efficacy of parecoxib for pain control after hysterectomy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of parecoxib versus placebo on pain intensity after hysterectomy.MethodsWe search PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases through March 2019 for randomized controlled trials (RCTs) assessing the effect of parecoxib versus placebo on pain intensity after hysterectomy. This meta-analysis is performed using the random-effect model.ResultsSix RCTs are included in the meta-analysis. Overall, compared with control group after hysterectomy, parecoxib treatment is associated with substantially reduced pain scores in 4-6 h at rest (MD = -0.98; 95%CI = -1.14 to -0.81; p < .00001), pain scores in 12 h at rest (MD = -0.70; 95%CI = -0.77 to -0.63; p < .00001), pain scores in 12 h on sitting up (MD = -0.90; 95%CI = -1.03 to -0.77; p < .00001), pain scores in 24 h on sitting up (MD = -1.19; 95%CI = -1.94 to -0.44; p = .002), dose of analgesic need in parecoxib group is notably lower than that in control group (std. MD = -2.54; 95%CI = -3.97 to -1.10; p = .0005), but shows no obvious effect on pain scores in 24 h at rest (MD = -0.40; 95%CI = -1.47-0.67; p = .47), pain scores in 4-6 h on sitting up (MD = -0.54; 95%CI = -2.50-1.42; p = .59), first time to analgesic requirement between two groups (std. MD = -0.10; 95%CI = -0.47-0.26; p = .57), nausea or vomiting (RR = 0.92; 95%CI = 0.59-1.43; p = .70), and adverse events (RR = 0.86; 95%CI = 0.64-1.17; p = .34).ConclusionsParecoxib treatment provides additional benefits for pain control after hysterectomy.

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