• Tanyong Pipanmekaporn, Yodying Punjasawadwong, Somrat Charuluxananan, Worawut Lapisatepun, Pavena Bunburaphong, Settapong Boonsri, Apichat Tantraworasin, and Nutchanart Bunchungmongkol.
• Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address: tanyong24@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2018 Feb 1; 32 (1): 302-308.

ObjectivesTo determine the incidence of ipsilateral shoulder pain (ISP) with the therapeutic use of parecoxib compared with a placebo after thoracotomy.DesignA prospective, randomized, double-blind, placebo-controlled trial.SettingA tertiary-care university hospital.ParticipantsAdult patients undergoing an elective thoracotomy between June 2011 and February 2015.InterventionsPatients were allocated randomly into the parecoxib group (n = 80) and the control group (n = 80). In the parecoxib group, 40 mg of parecoxib was diluted into 2 mL and given intravenously 30 minutes before surgery and then every 12 hours postoperatively for 48 hours. In the control group, 2 mL of normal saline was given to the patients at the same intervals.Measurements And Main ResultsA numerical rating scale was used to assess the intensity of ISP at 2, 6, 12, 24, 48, 72, and 96 hours after surgery. Intravenous morphine (0.05 mg/kg) was used as the rescue medication for ISP during the 96-hour period. Baseline characteristics of patients in both groups were comparable. Patients in the parecoxib group had a significantly lower incidence of ISP, both overall (42.5% v 62.0%, p = 0.014) and of moderate-to-severe ISP when compared with the control group (26.2% v 49.4%, p = 0.003). Parecoxib reduced the risk of ISP by a statistically significant 32% (risk ratio, 0.68; 95% confidence interval, 0.50-0.93, p = 0.016). There were no significant differences in the occurrence of adverse effects between the groups.ConclusionsIntravenous parecoxib significantly can reduce the incidence and severity of ISP after thoracotomy.Copyright © 2018 Elsevier Inc. All rights reserved.

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