Clinical Experiences with Parecoxib in the Treatment of Chronic Intractable Pain with Acute Manifestation in Pain Clinic

於疼痛門診以Parecoxib治療慢性頑固性疼痛之急性發作的臨床經驗

黃安年(John On-Nin Wong) ； 陳多慕(Thomas Dou-Moo Tan) ； 儲寧瑋(Ning-Wei Cheu) ； 王俞人(Yu-Ren Wang) ； 廖健雄(Chien-Hsiung Liao) ； 廖俐惇(Li-Tun Liao) ； 華淑芳(Mary Paul Watts)

《疼痛醫學雜誌》 20卷2期 (2010/09) Pp. 59-65

https://doi.org/10.29792/TTJP.201009.0002

摘要

Aim of Investigation: A newer COX-2 inhibitor Parecoxib has demonstrated powerful analgesic efficacy in well-documented clinical trials. It is the only injectable COX-2 inhibitor with fast onset and long-lasting analgesic effect. We report fifteen patients with acute attacks of severe pain under long-term regular treatment of chronic intractable pain of the head, chest, back, abdominal and extremity areas, in those treated with Parecoxib for pain relief, in our Pain Clinic.
Methods: Response was assessed before and after the injection of Parecoxib 40 mg intramuscularly, with follow-up for 24 hours. We evaluated the response to management using a verbal ranking scale which included a 0-10 pain intensity scale; profile of mood state induced by pain (0-3); quality of sleep (0-3) and activity status (Eastern Cooperative Oncology Group ”ECOG” Scale: 0-4). We also recorded patient satisfaction (Scale 0-4) and adverse effects during treatment with Parecoxib. Data was analyzed by paired Students t-test with p＜0.05 considered statistically significant.
Results: Fifteen patients were enrolled in this study and treated with Parecoxib, but only 13 cases had effective pain relief, and 2 cases failed. Among the 13 effective cases, 9 are male and 4 are female, with average age of 49.7 years (range: 34-88). All data showed in mean± SD, before and after treatment, included pain score 9.5±0.8 vs. 3.1±1.9; mood scale 2.7±0.5 vs. 0.4±0.5; sleep scale 2.2±0.7 vs. 0.1±0.3; and daily activity status, 1.4±0.7 vs. 0.2±0.4 respectively. The onset time was 10.3± 3.7 minutes and the duration of analgesia was 16.3±8.0 hours. The overall satisfaction was 3.7±0.5. All data compared before and after treatment was shown as statistically significant (p＜0.001). Moreover, there were no specific adverse effects ocurring during the course of treatment with Parecoxib.
Conclusions: Parecoxib is found to effectively treat chronic intractable pain as seen with acute manifestation in our pain clinic. Its analgesic efficacy obviously is fast onset and long duration, and it is effective not only in musculo-skeletal pain, but also in visceral, cancer-related, and neuropathic pain.

關鍵字

Parecoxib ； 慢性頑固性疼痛 ； 急性發作

並列摘要

Aim of Investigation: A newer COX-2 inhibitor Parecoxib has demonstrated powerful analgesic efficacy in well-documented clinical trials. It is the only injectable COX-2 inhibitor with fast onset and long-lasting analgesic effect. We report fifteen patients with acute attacks of severe pain under long-term regular treatment of chronic intractable pain of the head, chest, back, abdominal and extremity areas, in those treated with Parecoxib for pain relief, in our Pain Clinic.
Methods: Response was assessed before and after the injection of Parecoxib 40 mg intramuscularly, with follow-up for 24 hours. We evaluated the response to management using a verbal ranking scale which included a 0-10 pain intensity scale; profile of mood state induced by pain (0-3); quality of sleep (0-3) and activity status (Eastern Cooperative Oncology Group ”ECOG” Scale: 0-4). We also recorded patient satisfaction (Scale 0-4) and adverse effects during treatment with Parecoxib. Data was analyzed by paired Students t-test with p＜0.05 considered statistically significant.
Results: Fifteen patients were enrolled in this study and treated with Parecoxib, but only 13 cases had effective pain relief, and 2 cases failed. Among the 13 effective cases, 9 are male and 4 are female, with average age of 49.7 years (range: 34-88). All data showed in mean± SD, before and after treatment, included pain score 9.5±0.8 vs. 3.1±1.9; mood scale 2.7±0.5 vs. 0.4±0.5; sleep scale 2.2±0.7 vs. 0.1±0.3; and daily activity status, 1.4±0.7 vs. 0.2±0.4 respectively. The onset time was 10.3± 3.7 minutes and the duration of analgesia was 16.3±8.0 hours. The overall satisfaction was 3.7±0.5. All data compared before and after treatment was shown as statistically significant (p＜0.001). Moreover, there were no specific adverse effects ocurring during the course of treatment with Parecoxib.
Conclusions: Parecoxib is found to effectively treat chronic intractable pain as seen with acute manifestation in our pain clinic. Its analgesic efficacy obviously is fast onset and long duration, and it is effective not only in musculo-skeletal pain, but also in visceral, cancer-related, and neuropathic pain.

並列關鍵字

Chronic intractable pain ； Acute manifestation