COXIBS como alternativa a los opioides en el control de dolor agudo post operatorio en cirugía general

Abstract

Introduction: Acute pain is a subjective experience that can alter physiological homeostasis and psychological balance. Knowing the perception of pain is a prerequisite for any surgical pain treatment. Nowadays, opioid drugs are commonly used; an alternative is the non-steroidal anti-inflammatory drugs (NSAIDs) selective of COX-2 (COXIBS), which would avoid mild side effects of opioid administration, including nausea, vomiting, and pruritus, among others, and severe side effects, such as respiratory depression, tolerance, and dependence; therefore, they play a fundamental role in the management of postoperative pain. Literature Review: Intravenous (IV) Parecoxib reduces pain in oral and orthopedic surgery procedures, abdominal hysterectomy, laparoscopic cholecystectomy, and pancreaticoduodenectomy. It was equally effective as IV ketorolac and comparable to 4 mg of IV morphine. Cocristal tramadol-celecoxib (CTC) has the same efficacy as tramadol IV alone; CTC reduced the dose of tramadol and the side effects of the latter (increase in transaminases, pruritus, vomiting, and fatigue, among others). Etoricoxib and Parecoxib have a higher efficacy on the visual analog scale (VAS) than Celecoxib. Conclusion: The use of COX-2 selective anti-inflammatory drugs is an effective alternative for the management of acute postoperative pain; it reduces the use of opioids and avoids their side effects.