-
Randomized Controlled Trial
Short-term treatment with parecoxib for complex regional pain syndrome: a randomized, placebo-controlled double-blind trial.
- Anna J Breuer, Tina Mainka, Nora Hansel, Christoph Maier, and Elena K Krumova.
- Department of Pain Medicine, Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil GmbH Bochum, Ruhr University Bochum, Germany.
- Pain Physician. 2014 Mar 1;17(2):127-37.
BackgroundComplex regional pain syndrome (CRPS) is characterized by signs and symptoms of peripheral inflammation, which leads to peripheral neural sensitization associated most frequently (in about 70%) with blunt pressure hyperalgesia. Therefore, we hypothesized that treatment of CRPS patients with a selective COX-2-inhibitor would alleviate the abnormally low pressure pain threshold (PPT) and reduce pain intensity and edema.MethodsTwenty patients with CRPS type I (n = 16) and II of the upper limb and abnormally low PPT were double-blind randomised into 2 groups of 10 patients each to receive a 2-day intravenous treatment of either 80 mg parecoxib per day (group I) or placebo (NaCl 0.9%, group II). Standardized quantitative sensory testing (QST) using the DFNS protocol was performed before and after treatment. Pain intensity (NRS 0 - 10); circumferences of the fingers II, IV, and V (mm); PPT (kPa, thenar/hypothenar); and adverse events were recorded daily.StatisticsWilcoxon-test, Mann-Whitney-U-test, Friedman-test, Fisher-test, significance level: P < 0.05.Study DesignProof of concept trial performed in randomized, placebo-controlled, double blind style .SettingPain Management Center in Germany.ResultsThere were no group differences in PTT or other QST parameters. After treatment, PPT decreased insignificantly in group I (median [range]; before: 224.0 [121.0 - 52937] kPa, afterwards: 186.4 [101.4 - 526.5] kPa) and increased insignificantly in group II (before: 207.6 [170.0 - 320.5] kPa; afterwards: 235.4 [163.5 - 349.9] kPa). Pain scores and finger circumferences remained unchanged in both groups.LimitationsDue to difficulty in recruitment the trial was closed after inclusion of 20 patients.ConclusionIn the present proof-of-concept trial, short-term treatment with the selective COX-2-inhibitor parecoxib influenced neither PPT nor edema or pain. COX-2 might be less important than previously assumed. However, the results are limited due to the small number of patients, short-term treatment, and focus on the PPT, which could have led to false negative results of the present study and covered the expected therapeutic effect.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.