• Hui-Ming Peng, Long-Chao Wang, Wei Wang, Qi-Heng Tang, Wen-Wei Qian, Jin Lin, Jin Jin, Bin Feng, Xing-Hua Yin, Xi-Sheng Weng, and Yi-Xin Zhou.
• Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
• Pain Physician. 2018 Sep 1; 21 (5): 483-488.

BackgroundTotal hip arthroplasty (THA) is a well-accepted surgical treatment for terminal hip diseases.ObjectiveTo evaluate the effect of preemptive analgesia with parecoxib in patients undergoing primary unilateral THA.Study DesignA randomized, double-blind, placebo-controlled study.SettingThis study was conducted at Peking Union Medical College Hospital and Beijing Jishuitan Hospital in Beijing, China.MethodsA total of 94 patients scheduled for primary unilateral THA in 2 centers (Peking Union Medical College Hospital and Beijing Jishuitan Hospital) were randomly assigned to receive 40 mg parecoxib (n = 48) or 0.9% normal saline solution (n = 46) 30 minutes before incision. All patients received standardized intravenous patient-controlled analgesia (PCA) postoperatively. Preoperative baseline data, surgery-related conditions, postoperative Visual Analog Scale (VAS) pain score, cumulative narcotic consumption of PCA, and complications were compared between the parecoxib group and the placebo group.ResultsThere were no significant differences in postoperative VAS pain score, cumulative narcotic consumption of PCA, proportion of analgesic remedy, and complications between the 2 groups.LimitationsOnly a single dose of parecoxib was used without including a dose-dependent control group.ConclusionA single dose of parecoxib 30 minutes before incision did not provide effective preemptive analgesia for the management of postoperative pain after primary unilateral THA. The possible effect of preemptive analgesia with parecoxib needs further investigation.Key WordsTotal hip arthroplasty, pain, parecoxib, COX-2 selective inhibitor, preemptive analgesia, clinical trial, patient-controlled analgesia, analgesics.

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