Comparative study between injection parecoxib and butorphanol for postoperative analgesia in laparotomy patients

Dnyaneshwar R. Fating, N. G. Tirpude


Background: Pain is a complex, subjective experience comprising both physical and emotional components. Upper abdominal surgeries cause most intense pain and distress. Opioids and Nonsteroidal anti-inflammatory drugs are used for postoperative analgesia. Aim of this study was to compare the efficacy of analgesia between injection parecoxib and butorphanol.

Methods: Prospective randomised comparative study included total 60 patients posted for laparotomy under general anaesthesia. Patients were randomly allocated in two groups. One group received injection paecoxib sodium (Group-P) and other group received injection Butorphanol (Group- B) half an hour before extubation. Pain score was recorded as per visual analogue scale at 0, 4,8,12 hours. The side effects if any were recorded and vomiting and sedation score was recorded.

Results: Immediately in postoperative period VAS was less in Group B, but at 8 hours. VAS was less in Group P.

Conclusions: Parecoxib has better quality of pain relief, minimal side effects compared to butorphanol which has good analgesia in immediate postoperative period.


Analgesia, Butorphanol, Laparotomy, Parecoxib sodium

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IASP Sub-Committee on taxology .pain terms: a list with definition and notes on usage. Pain 1980;8:249-52

Jonathan Richardson, Sabaratnam Sabanathan. Prevention of respiratory complications after abdominal surgery. Thorax1997; 52(suppl3): 35-40.

Joris J. Efficacy of nonsteroidal ant-inflammatory drugs in postoperative pain. Acta Anaesthesia Belg. 1996;47(3):115-23.

Cheer SM, Goa KL. Parecoxib Sodium. Drugs. 2001; 6(8):1133-41.

Gilbert et al. Intramuscular butorphanol and meperidine in postoperative pain. Clin Pharmacol Ther. 1976; 20(3):359-64.

Carol A. Bodian et al. The Visual Analog scale for pain. Anaesthesiology; 95:1356-61.

A. Y. Oh et al. Incidence of postoperative nausea and vomiting after paediatric strabismus surgery with sevoflurane and remifentanil. British Journal of Anaesthesia. 2010; 104(9): 756-60.

Ramsay et al. Controlled Sedation with alphaxolone- alphadalone. BMJ. 1974;2: 656-659.

Karim A, Lauret A, et al. A pharmacokinetic study of intramuscular parecoxib sodium in normal subjects. J. Clin. Pharmacol. 2001: 41(10)1111-9.

Barbara Ameer and Fred J. Salter. Drug therapy reviews: Evaluation of Butorphanol tartrate: Am J Hosp Pharm. 1979; 36: 1683-1691

D. A. Laffey and N. H.Key. Premedication with butorphanol. British Journal of Anaesthesia. 1984; 56:363

Rasmussen G. L., K Steckner, et al. Intravenous parecoxib sodium for acute pain after orthopaedic knee surgery. Ann. J. Ortho. 2002; 31(6):336-43.

Borton SF et al. Efficacy and safety of intravenous parecoxib sodium in relieving acute postoperative pain following gynaecologic laparotomy surgery. Anesthesiology. 2002; 97(2):306-14.

Malan TP Jr, Gordon S, et al. The cyclooxygenase-2 specific inhibitor parecoxib sodium is as effective as 12 mg of morphine administered intramuscularly for treating pain after gynaecologic laparotomy surgery. Anaesth Anal. 2005;100(2):454-60.

Joshi GP et al. Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral cox-2 specific inhibitor. Anesth Analg. 2004; 98(2):336-42.

Ng A, Smith G, David AC. Analgesic effects of parecoxib following total abdmoninal hysterectomy. British Journal of Anaesthesia. 2003; 90(6)746-9.

Vidyashri Kamath, Adeline Lasrado. Efficacy and safety of intravenous acetaminophen versus intravenous butorphanol as postoperative analgesic in obsteretic and gynaecology. Int J Adv Med. 2014; 1(3):222-229.

Tang M. D., Shitong Li, et al. Effect of parecoxib, a novel intravenous cyclooxygenase-2 inhibitor on the postoperative opioid requirement and quality of pain control. Anaesthesiology. 2002; 96:1305-9.

Daniels S. E, et al. A double blind randomised comparison of intramuscularly and intravenously administered paecoxib sodium versus ketorolac and placebo in a postoperative oral surgery pain model. Clin. Ther. 2001; 23 (7):1018-31.

Vijaykumar Ramiah et al. Comparison of parecoxib and butorphanol as adjuvant to lignocaine in intravenous regional anaesthesia. Anaesthesiology. 2006; 105:A1129