Early analgesic effects of intravenous parecoxib and rectal diclofenac following laparoscopic sterilization: A double-blind, double-dummy randomized controlled trial


  • Alexander Ng, MD, FRCA
  • Ajay Swami, FFARCSI
  • Graham Smith, MD, FRCA
  • Joe Emembolu, FRCOG




analgesics anti-inflammatory, cyclooxygenase- 2 inhibitors, analgesics nonopioid, diclofenac, parecoxib, randomized trial


The aim of this double-blind double-dummy randomized controlled trial was to investigate if there was any difference in analgesia between the maximum recommended doses of rectal diclofenac and iv parecoxib after laparoscopic sterilization. The authors studied 55 ASA I-II patients undergoing gynecological laparoscopy; each patient received either preoperative rectal diclofenac 100 mg and 2 mL of normal saline at induction of anesthesia, or preoperative placebo suppository and 2 mL of parecoxib 40 mg at induction. Pain intensity, sedation, and nausea were measured using a 100-mm visual analogue scale on awakening and at 1, 2, and 3 hour postoperatively. Median (interquartile range) pain intensity at rest on awakening and at 1, 2, and 3 hour postoperatively were 15 (0-40), 37 (10-56), 16 (6-29), and 13 (2-32) mm, respectively, in the parecoxib group, and 3 (0-34), 22 (5-45), 24 (6-37), and 10 (4-21) mm, respectively, in the diclofenac group. There was no significant difference in these scores. Furthermore, there was no significant difference between the two groups in sedation, nausea, rescue analgesia, or rescue antiemetic consumption. Preoperative rectal diclofenac 100 mg and parecoxib 40 mg iv at induction of anesthesia were found to have equianalgesic effects after laparoscopic sterilization. Both drugs appear to be useful after short anaesthetics.

Author Biographies

Alexander Ng, MD, FRCA

Present Address and Author for Correspondence: The Heart and Lung Centre, New Cross Hospital, Wolverhampton, WV10 0QP, United Kingdom; University Division of Anaesthesia, Critical Care and Pain Management, Leicester Royal Infirmary, Leicester, United Kingdom.

Ajay Swami, FFARCSI

University Division of Anaesthesia, Critical Care and Pain Management, Leicester Royal Infirmary, Leicester, United Kingdom.

Graham Smith, MD, FRCA

University Division of Anaesthesia, Critical Care and Pain Management, Leicester Royal Infirmary, Leicester, United Kingdom.

Joe Emembolu, FRCOG

Department of Obstetrics and Gynaecology, Leicester Royal Infirmary, Leicester, United Kingdom.


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How to Cite

Ng, MD, FRCA, A., A. Swami, FFARCSI, G. Smith, MD, FRCA, and J. Emembolu, FRCOG. “Early Analgesic Effects of Intravenous Parecoxib and Rectal Diclofenac Following Laparoscopic Sterilization: A Double-Blind, Double-Dummy Randomized Controlled Trial”. Journal of Opioid Management, vol. 4, no. 1, Jan. 2018, pp. 49-53, doi:10.5055/jom.2008.0008.