• Heiko Neuss, Gerold Koplin, Oliver Haase, Christian Reetz, and Julian W Mall.
• Department of General, Visceral, Thoracic, and Vascular Surgery, Medical Faculty of the Humboldt University, Berlin, Germany. heiko.neuss@charite.de
• J. Surg. Res. 2010 Jul 1;162(1):88-94.

BackgroundAnalyzing prospective data of our melanoma patients, we registered a suboptimal pain score under mobilization after radical axillary lymph node dissection (RALND). We performed a randomized, double blinded clinical trial to investigate the effects of a preemptive Parecoxib analgesic during the perioperative course.Materials And MethodsBetween October 2006 and December 2007, 32 patients with stage III/IV melanoma underwent therapeutic RALND and were randomized into two groups. Patients received intravenously 40 mg Parecoxib or 0.9% normal saline solution 2 h before RALND. The postoperative treatment and analgetic regime was defined in the study protocol. Main outcome criterion was the pain under mobilization at the first postoperative morning registered via a visual analogue score. Minor criteria were the postoperative complications, fatigue, amount of analgesics, and the day of discharge.ResultsPatients receiving a preemptive analgesic had a better outcome after RALND. The pain after mobilization was significantly decreased at the first postoperative morning (P = 0.04). Patients had less fatigue as well (P = 0.05) and the amount of pain medication in the treatment group was reduced (P = 0.04).ConclusionsPreemptive application of Parecoxib enhances outcome after RALND. A preemptive analgesic with Parecoxib in the perioperative management after RALND of melanoma patients can be recommended.(c) 2010 Elsevier Inc. All rights reserved.

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